Medicine and Health Sciences Commons^™

Chronic Illness Education 2025: Persistent Obesity In A College Student: A Case For Investigating Endocrine Disruptors In Diet, Jake Mcgue, Jolyna Chiangong, Katarina Woldt, Mary-Ann Essak, Muiz Muqri, Nikhil Patel, Redi Gishto

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Exercise Initiatives To Improve Child Obesity, Alice Werynski, Ashley Simbafo, Diana Kernen, Koa Williams, Linda Beqaj, Noah Krepostman, Trevor Buck

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Empowering Families With Resources To Combat Childhood Obesity, Abisola Fasakin, Alqasim Elnaggar, David Abdelnour, Mujeebah Kamal-Muili, Prit Patel, Ryan Palazzolo, Sydney Huston

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: Improving The Understanding Of The Complexities Underlying Adult Obesity, Ethan Montoya, Maria Villalba, Morzouk Lawal, Nataliah Jwaida, Safa Razvi, Susan Lagrand, Vittal Ashwin Kandukuri, Robert Chalhoub

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: A Highly Misunderstood, Multifactorial Disease, Alexa Maruszewski, Ali Eidy, Chelsea Kumi, Hailey Hartmann, Jacob Pawlowski, Kinan Suliman, Laura Garcia, William Davie

Patient Education Projects

No abstract provided.

Chronic Illness Education 2025: School-Centered Interventions To Address Childhood Obesity, Aaron Yang, Amanda York, James Mcknight, Madison Jordan, Myron Shaba, Riley Marchin, Rita Pisegna, Constantine Tangalos

Patient Education Projects

No abstract provided.

Clinical Outcomes After Hospitalization For Acute Coronary Syndrome In Patients Treated With Semaglutide Versus Bariatric Surgery: A Retrospective Multicenter Analysis, Nameer Ascandar, Charles Boadu, Gauthier Stepman, George Skaf, Olugbenga Oyesanmi, Sabry Omar, Rias Ali, Michael Schandorf-Lartey

HCA Healthcare Journal of Medicine

Background

Obesity is a chronic medical condition with a rising prevalence in the United States. A wide range of morbidity and mortality is associated with obesity, with coronary artery disease being among the most common. Ischemic heart disease continues to be the primary cause of death in the United States. Taken together, interventions to minimize the detrimental effects of obesity on patients at risk of heart disease will not only benefit the patient, but the health care system as well.

Methods

In this retrospective study, we used the HCA Healthcare enterprise data warehouse to identify all adult patients who were …

"The Growing Burden: Overweight And Obesity Prevalence And Risk Factors Among Medical College Students In Mysuru: A Cross-Sectional Study", Akansha ., Nayanabai Shabadi, Anchu R Nath, Ravipati Manogna

Digital Journal of Clinical Medicine

ABSTRACT:

Background:

The transition from adolescence to adulthood is often accompanied by significant lifestyle changes, including changes in dietary habits, physical activity levels, and stress, which can contribute to unhealthy weight gain. In India, the prevalence of overweight and obesity among youth has shown an upward trend, raising concerns about early onset of non-communicable diseases. This study aims to assess the prevalence of overweight and obesity among degree college students in Mysuru and to identify the associated socio-demographic and lifestyle factors contributing to these conditions.

Methodology:

A cross-sectional study was conducted over three months, from January to March 2025, among …

Impact Of Lifestyle Factors On Breast Cancer Risk And Outcomes: A Scoping Review, Nada Alhazmi

Journal of King Abdulaziz University: Medical Sciences

Aim: This scoping review summarizes evidence on the impact of environmental factors on breast cancer risks and outcomes.

Methodology: A systematic search was performed on PubMed, CINAHL, and ScienceDirect to identify peer-reviewed, English-only sources published between 2020 and 2025 on the impact of lifestyle factors on breast cancer risk and outcomes.

Results: A total of 15 studies (three cohort studies, two cross-sectional studies, five systematic reviews, four narrative reviews, and one case-controlled study) met the inclusion criteria. Evidence from the sources identified physical inactivity, unhealthy diet, obesity, alcoholism, tobacco smoking, menopause, and delayed first-first as lifestyle factors that impact breast …

Binge Eating Disorder: A Clinical Review, Michell Mcdiffett Mshs, Pa-C

Lynchburg Journal of Medical Science

Binge eating disorder (BED) is the most common eating disorder (ED) in the United States (U.S.) and is characterized by recurrent episodes of eating a larger than normal amount of food in a discrete period of time and includes a sense of loss of control over food intake. BED is often comorbid with serious somatic and psychiatric disorders and is associated with reduced quality of life and excess mortality. Some consider BED a public health concern due to frequent co-occurrence with obesity and worse outcomes in those populations. The diagnosis is often delayed due to shame and underreporting of symptoms …

Obesity And Its Effect On Work Performance, Erin Lajoie

Lynchburg Journal of Medical Science

This research aims to examine how obesity affects work productivity and performance and how companies can support their employees diagnosed with obesity. Obesity is a growing global health concern that has significant implications for decreased workplace productivity and performance. Obesity is considered a chronic complex disease often associated with hypertension (HTN), type-II diabetes mellitus (T2DM), and heart disease that can lead to overall increases in healthcare costs for employers through increased absenteeism, presenteeism, and decreased efficiency. A systemic literature search was completed using PubMed, Cochrane Library, and Google Scholar, identifying multiple journal articles about obesity and productivity in the workplace …

Investigation Of The Relationship Between Triglyceride Glucose Index And Metabolic And Hematological Parameters In Obese Individuals, Özge Baş Aksu, Feri̇de Özkara, Rifat Emral, Volkan Genç, Demet Çorapçioğlu, Mustafa Şahi̇n

Turkish Journal of Medical Sciences

Background/aim: This research examined the association between the triglyceride-glucose (TyG) index and metabolic, hepatic, and hematologic variables in a population of severely obese subjects, with a focus on the assessment of glycemic control.

Materials and methods: This retrospective study included 315 adult patients with a body mass index (BMI) ≥ 35 kg/m² who were evaluated for bariatric surgery. Participants were grouped according to HbA1c levels: those with HbA1c ≥ 6.5% and those with HbA1c < 6.5%. TyG, atherogenic index of plasma (AIP), fibrosis-4 (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and hematological inflammation markers were assessed and compared between groups. To investigate associations, correlation and regression analyses were conducted.

Results: Individuals with HbA1c ≥ 6.5% had significantly higher TyG, AIP, APRI, and FIB-4 values than those with lower HbA1c. The TyG index showed a strong …

Transgenerational Obesity Modulation Of Gut Mucosal Immunity, Chen-Ting Hung, Justin Kern, Tihana Trsan, Santosh K Panda, Marie Laury, Umang Jain, Marco Colonna, Thaddeus S Stappenbeck, Ta-Chiang Liu

2020-Current year OA Pubs

The prevalence of obesity in the United States has continued to increase over the past several decades. A growing concern is that transgenerational effects of obesity negatively impact physiologic functions. We showed that consumption of a high fat, high sugar "Western" diet (WD) decreased the density of both gut innate (Paneth cells) and adaptive immune cells (intraepithelial lymphocytes; IEL). We asked whether consumption of WD impacts gut mucosal immunity in the offspring. WD-mediated Paneth cell loss was reversible, whereas IEL loss was not. However, the overall composition of the fecal microbiome and response to infection were defined by the diet …

Triterpenoid Cddo-Ea Protects From Hyperglycemia, Hyperinsulinemia, And Obesity By Decreasing Energy Intake, Austin E. Cantu, Cordelia Rasa, Shizue Mito, Denae Cantu, Juan Lopez-Alvarenga, Leslie L. Rivera-Lopez, Israel Rios, Ashley Abrego-Gonzalez, Sara M. Reyna

School of Medicine Publications

Obesity is a significant factor in the development of type 2 diabetes (T2D). Treatment of obesity is pivotal in the prevention and management of T2D, and the development of new pharmacological therapies are studied for improving insulin resistance and glucose intolerance. Oleanolic acid-derived triterpenoids, 2-cyano-3,12-dioxoolean-1,9-dien-28-oic acids (CDDOs), are studied to elucidate the mechanisms by which they protect against obesity. However, fundamental knowledge gaps remain regarding the physiological and molecular mechanisms by which CDDOs protect against obesity. Our recently published studies showed that CDDO-ethyl amide (CDDO-EA) prevents skeletal muscle inflammation by inhibiting activation of nuclear factor-kappa B (NF-κB) signaling. Moreover, CDDO-EA …

Effects Of Cerebral Tumor Necrosis Factor Alpha On Systemic Glucose Homeostasis In Obese Mice, Gabriela Griepp

Honors Projects

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by impaired blood glucose regulation and persistent hyperglycemia. The central nervous system functions as a key regulator in the maintenance of peripheral normoglycemia. Obesity, commonly associated with T2DM, often leads to chronic inflammation in the hypothalamus, a critical brain center for integrating metabolic feedback and controlling outputs to peripheral organs. However, the physiological mechanisms through which obesity-induced brain inflammation affects glucose regulation remain somewhat unclear. Previous studies have linked one key pro-inflammatory cytokine, tumor necrosis factor alpha (TNF-α), to metabolic function and glycemic control; however, the exact nature of its …

Adipocyte/Tumor Cell Crosstalk Via Igf-1/Txnip Axis Promotes Malignancy And Endocrine Resistance In Breast Cancer, Amanda Caruso, Felice Maria Accattatis, Cinzia Giordano, Luca Gelsomino, Piercarlo Del Console, Maria Francesca Fiorita, Balazs Gyorffy, Laura Bianchi, Alfonso Carleo, Rossana De Salvo, Bruno M Simões, Robert B Clarke, Lorenzo Memeo, Cristina Colarossi, Eleonora Aiello, Francesco Conforti, Suzanne A W Fuqua, Matilde Todaro, Giorgio Stassi, Catia Morelli, Diego Sisci, Daniela Bonofiglio, Stefania Catalano, Sebastiano Andò, Ines Barone

Faculty, Staff and Students Publications

Background: Despite significant improvements in the outcome of Estrogen Receptor (ER) α-positive breast cancer (BC) following the use of endocrine therapies, resistance remains a major challenge. Clinical studies proved that obesity, in addition to promote BC progression, is associated with a reduced efficacy to these treatments, but mechanisms remain unclear.

Methods: We used co-culture systems followed by validation through an ‘ex vivo’ model of human mammary obese (Ob) adipocytes and obese endocrine-resistant metastatic Patient-Derived Organoids (PDOs). Transcriptomics with MixOmics-MINT and MetaCore Functional Tools along with lentiviral and pharmacological approaches provide insights into mechanisms. Clinical relevance was investigated using public datasets, …

Plasma Insulin-Like Growth Factor-Binding Protein-7 Is Positively Associated With Age, Obesity, Mortality, And Cancer In Postmenopausal Women, Melissa C Orenduff, Carl F Pieper, Emma H Allott, Michael F Coleman, Su Yon Jung, Mara Z Vitolins, Jenifer I Fenton, Chu Chen, Candyce H Kroenke, Fred K Tabung, Ana Barac, Electra D Paskett, Michael N Pollak, Jennifer Hays-Grudo, Shine Chang, Stephen D Hursting

Faculty, Staff and Student Publications

Background: Predictors of premature death and cancer development are needed to more precisely identify individuals who may warrant preventive intervention. Circulating insulin-like growth factor (IGF)-binding protein-7 (IGFBP7) and, to a lesser extent, the IGFBP7/IGF-1 ratio are emerging biomarkers of renal and cardiovascular morbidity. However, their relationships with aging, obesity, mortality, and cancer risk remain unclear.

Methods: This hypothesis-generating study investigated plasma IGFBP7, IGF-1, and their ratio as predictors of all-cause mortality and the incidence of any cancer (excluding nonmelanoma skin cancer), obesity-related cancer (composite of 13 cancer types), and breast cancer in a large longitudinal cohort of postmenopausal women. We …

Impact Of Metabolically Healthy Obesity On Post Percutaneous Coronary Intervention Outcomes In Patients With Acute Myocardial Infarction: A Nationwide Propensity Matched Analysis, Rupak Desai, Adhvithi Pingili, Arankesh Mahadevan, Vishal Reddy Bejugam, Hafeezuddin Ahmed, Vamsikalayan Borra, Adil Sarvar Mohammed, Gayatri Bondi, Shobana Krishnamurthy, Nithya Borra

School of Medicine Publications

Background

Obesity paradox in post-percutaneous coronary intervention (PCI) outcomes among acute myocardial infarction (AMI) patients is a known controversy. However, these studies included patients who had diabetes, hypertension, or hyperlipidemia. We studied relationship between metabolically healthy obesity (MHO—without diabetes, hypertension, or hyperlipidemia) and in-hospital post-PCI outcomes among AMI patients.

Methods

We extracted data from National Inpatient Sample 2020 using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for admissions of AMI patients who underwent PCI. We then identified patients with diabetes, hypertension, and hyperlipidemia using Elixhauser comorbidity index and Clinical Classifications Software and excluded them. Then, using Elixhauser …

Digesting The Details: How Cooking Shapes The Microbiome And Influences Obesity, Tracy Lieu

University Honors Theses

Obesity is a growing global health concern linked to chronic diseases and changes in the gut microbiome. While diet is known to affect gut microbes, less attention has been given to how food processing methods, such as heating, fermentation, and cold processing, change food in ways that influence the gut microbiome and health. This thesis reviews research on how different cooking and preparation techniques affect the availability of nutrients for microbial fermentation and the resulting effects on microbial diversity and metabolism. The findings show that fermentation and cold processing are the most supportive of gut health. These methods help preserve …

Time To Weight Plateau With Tirzepatide Treatment In The Surmount-1 And Surmount-4 Clinical Trials, Deborah B Horn, Scott Kahan, Rachel L Batterham, Dachuang Cao, Clare J Lee, Madhumita Murphy, Sylvia Gonsahn-Bollie, Farai Chigutsa, Adam Stefanski, Julia P Dunn

Faculty, Staff and Student Publications

The rate of weight reduction during obesity treatment declines over time and eventually reaches a weight plateau. We investigated factors associated with time to weight plateau (TTWP) in tirzepatide-treated participants with obesity or overweight in a post-hoc analysis of SURMOUNT-1 and SURMOUNT-4 trials. Participants adherent to tirzepatide treatment and achieving ≥5% weight loss by primary endpoint (week 72 SURMOUNT-1; week 88 SURMOUNT-4) were included. Weight plateau was defined as a weight change < 5% over a 12-week interval and all subsequent 12-week intervals. TTWP was time from randomization to the start of the first 12-week interval. Association between baseline characteristics and TTWP was assessed. Overall, 1438 participants in SURMOUNT-1 and 259 in SURMOUNT-4 were included. Across BMI categories (overweight, class I, II, and III), median TTWP in SURMOUNT-1 was 24.3, 26.0, 36.1, and 36.1 weeks, respectively (p < .05, class II and III vs. overweight). By week 72, 90.2%, 88.9%, 87.6%, and 87.8% of participants in SURMOUNT-1 had reached a weight plateau across respective BMI categories [Correction added on 22 January 2025, after first online publication: The "72%" has been changed to "72" in this version.]. Higher doses of tirzepatide (10/15 mg), younger age, and female sex were more likely to reach a weight plateau later. Results in SURMOUNT-4 were similar. In this post-hoc analysis, most participants reached a weight plateau by week 72. Higher doses of tirzepatide, younger age, and female sex were associated with a longer TTWP. Further research into modifiers of weight reduction phases with tirzepatide may inform treatment decisions for its use in chronic weight management. Clinical Trial Registration: ClinicalTrials.gov, identifiers NCT04184622 (SURMOUNT-1) and NCT04660643 (SURMOUNT-4), available at http://www.clinicaltrials.gov/.

Cysteine Depletion Triggers Adipose Tissue Thermogenesis And Weight Loss, Aileen H Lee, Irina Shchukina, Prabhakar Sairam Andhey, Maxim N Artyomov, Et Al.

2020-Current year OA Pubs

Caloric restriction and methionine restriction-driven enhanced lifespan and healthspan induces 'browning' of white adipose tissue, a metabolic response that increases heat production to defend core body temperature. However, how specific dietary amino acids control adipose thermogenesis is unknown. Here, we identified that weight loss induced by caloric restriction in humans reduces thiol-containing sulfur amino acid cysteine in white adipose tissue. Systemic cysteine depletion in mice causes lethal weight loss with increased fat utilization and browning of adipocytes that is rescued upon restoration of cysteine in diet. Mechanistically, cysteine-restriction-induced adipose browning and weight loss requires sympathetic nervous system-derived noradrenaline signalling via …

Life In The Fast Lane: Improving Patient Intermittent Fasting Compliance, William C. Moreo

Doctor of Nursing Practice Final Manuscripts

Background: In the United States, 2 in 5 adults are obese. The U.S. spends approximately $147 billion annually on healthcare related to obesity. Intermittent Fasting (IF) has emerged as an evidence-based, safe, and cost-effective approach to weight loss. When instructed correctly, it has been shown to improve patient BMI and total weight over a short-term duration.

Purpose of the Project: The purpose of this study was to determine the effectiveness of a standardized time-restricted eating (TRE) intermittent fasting education protocol for primary care providers (PCP) and its impact on their confidence levels in managing patients. This project aims to enhance …

“Non-Markovian” And “Directional” Errors Inhibit Scientific Self-Correction And Can Lead Fields Of Study Astray: An Illustration Using Gardening And Obesity-Related Outcomes, Jon Agley, Sarah E Deemer, David B Allison

Children’s Nutrition Research Center Staff Publications

Herein we coin the terms non-Markovian error and biased Markovian error to describe categories of scientific errors for which general progress within a field of study may be unlikely to result in scientific self-correction. We provide examples of such errors and show their impact on studies about gardening and obesity.

Rural And Urban Disparities In Access To Glp-1 Agonists For Patients With Obesity, Christine J. Hackler-Moorman

MUSC Theses and Dissertations

The increasing interest in glucagon-like peptide-1 (GLP-1) agonists, such as semaglutide, which are often prescribed as a first-line treatment for managing Type II diabetes, as well as for non-diabetic purposes—such as weight management and improving metabolic health—highlights their potential in preventive care. This promise inspires hope for a future where preventive healthcare is more effective and accessible to a wider audience. Nonetheless, significant geographic disparities in access to healthcare, especially between rural and urban areas, create obstacles that prevent numerous patients from reaping the benefits of these essential medications. In rural communities, challenges like cost, availability, and awareness are often …

Physiologically Based And Population Pharmacokinetic Modeling Of Midazolam In Children With Obesity Using Real-World Data, Sean Mccann, Victória E. Helfer, Stephen J. Balevic, William J. Muller, John N. Van Den Anker, Amira Al-Uzri, Marisa L. Meyer, Sarah G. Anderson, Sitora Turdalieva, Andrea N. Edginton, Daniel Gonzalez, Best Pharmaceuticals For Children Act Pediatric Trials Network Steering Committee

Department of Pediatrics Faculty Papers

Children represent a highly complex and variable population for treatment, including interindividual differences in drug dose-exposure. Midazolam has been used as a sedative for hospitalized children on- and off-label; however, factors affecting interindividual variability (IIV) in observed clearance for this population are not fully understood and can result in extreme under- or overexposure. Obesity has been described as a significant influence on midazolam in adolescents, which could potentially alter drug exposure. The goal of this study was to use two modeling strategies to evaluate dose-exposure of midazolam in children with and without obesity. Population pharmacokinetic modeling assessed whether measures of …

Mesoderm-Specific Transcript Has A Role In The Systemic Regulation Of Obesity, Maria J. Orellana Rosales

Thinking Matters Symposium

Mesoderm specific transcript (Mest) expression in white adipose tissue (WAT) is variable in genetically identical mice. Previous studies have shown a connection between Mest high expression and propensity for fat mass expansion. WAT and liver crosstalk has been well documented with hormone-like peptides signaling and regulating important metabolic pathways. The aim of this study is to investigate the correlation between these circulating factors and Mest expression in mice after exposure to a high fat diet (HFD). A group of 120 C57B6/J mice, males and females, were exposed to a HFD (Western Diet, 40 kcal% fat) for 4 weeks (8-12 weeks …

A Local Assessment Of Glp-1 Use For Weight Loss: An Interview Study, Maci Bradley

Honors Theses

Glucagon-like peptide-1 (GLP-1) receptor agonists are a novel class of medications used primarily for the treatment of type 2 diabetes, as well as for chronic weight management. The first GLP-1 medication, exenatide, was FDA-approved in April of 2005 for glycemic control, however, it was not until December of 2014 when liraglutide became the first GLP-1 FDA-approved for weight loss. There are now eight FDA-approved GLP-1s, only two of which are approved for weight loss. GLP-1 use has become increasingly popular in recent years, even extending to the college-aged population. The purpose of this study is to examine the trends in …

Investigating The Association Between Metabolically Healthy And Metabolically Unhealthy Obesity With Disease, Colleen Marie Cohick

Walden Dissertations and Doctoral Studies

Obesity is a global health concern, affecting individuals of all ages and ethnicities worldwide. A key factor in health concerns related to obesity is metabolic health: Obese individuals are either metabolically healthy obese or metabolically unhealthy obese, leading to different degrees of risk for cardiovascular disease and diabetes.. There is a lack of comprehensive research examining the association between metabolic health status among obese individuals and kidney, liver, and stomach diseases. This quantitative cross-sectional study was conducted to examine whether metabolic health status is a significant predictor of kidney, liver, and stomach diseases among obese individuals when lifestyle is a …

The Association Of Resistin With Metabolic Health And Obesity In A Mexican-American Population, Reem Al-Dallal, Keziah Thomas, Minjae Lee, Aysha Chaudhri, Eleanor Davis, Priyanka Vaidya, Miryoung Lee, Joseph B Mccormick, Susan P Fisher-Hoch, Absalon D Gutierrez

Faculty, Staff and Student Publications

Research on the relationship between resistin levels, metabolic health, and obesity has produced inconsistent findings across different ethnic groups, making it unclear whether lower resistin levels are associated with these conditions in Mexican-Americans. This cross-sectional study investigated the relationship between resistin, metabolic health, and obesity in an adult Mexican-American cohort (n = 1511) using multivariable linear regression analysis. Related adipokines (leptin and adiponectin) were measured simultaneously. Participants were categorized into four groups by metabolic health (healthy/unhealthy) and obesity (obese/non-obese) status. “Metabolically unhealthy” was defined as ≥2 cardiometabolic abnormalities. Obesity was defined as a BMI ≥ 30 kg/m2. We also …

Glp1 Receptor Agonist Increases Fracture Risk In Patients With Obesity, Alex T. Chelton, Ethan R. Lawson, Francis E. Jenney

Research Day

Introduction: GLP-1 receptor agonist medication usage has seen a rapid increase in usage not only for diabetic patients but now for obese and overweight patients who are searching for alternative weight loss methods. Although these medications are proving useful for helping patients lose weight, there are notable side effects that patients need to consider.

Methods: A retrospective case-control study was conducted using data from the NIH All of Us database. Patients were included based on the diagnosis of overweight and obesity. Patients were excluded based on diagnosis of type 1 or type 2 diabetes mellitus, A1c > 6.5 and diagnosis of …