Citations 3
S1667 Appetite-Related Physiological Adaptations to a Low-Calorie, Low-Fat Diet in Obesity Compared to Normal Weight
Mcrae, Alison, Ricardo, Maria Laura, Cifuentes, Lizeth , Calderon, Gerardo, Gonzalez, Daniel, Hurtado, Maria D. , Acosta, Andrés
American Journal of Gastroenterology | October 18, 2023 | Volume: 118 | Issue: 10S | Pages: S1247-S1247
Effect of caloric intake and macronutrient composition on intestinal cholesterol absorption and bile acids in patients with obesity
Hashem, Anas , Cifuentes, Lizeth , Ricardo-Silgado, Maria Laura , Gonzalez‐Izundegui, Daniel, Campos, Alejandro , Mcrae, Alison, Franks, Shawna, Burton, Duane, Petterson, Xuan-Mai, Camilleri, Michael , Hashem, Anas Mohamad , Calderon, Gerardo, Gonzalez-Izundegui, Daniel, Hurtado, Maria Daniela , Lanza, Ian R , Camilleri, M , Acosta, Andres , Campos, Alejandro , Calderon-Lopez, Gerardo , Hurtado, Maria D. , Lanza, Ian R. , Acosta, Andrés
American Journal of Physiology-Gastrointestinal and Liver Physiology | June 21, 2022 | Volume: 323 | Issue: 3 | Pages: G157-G164
We show how switching from a regular diet to an HCHF increases cholesterol absorption in patients with normal weight and obesity. The decrease in cholesterol absorption from an HCHF to an LCLF, on the other hand, was only seen in normal-weight controls, underlining the importance of body weight in this regulation. In addition, changes in caloric and fat content had an immediate and direct effect on hepatic bile acid production.
Selection of Antiobesity Medications Based on Phenotypes Enhances Weight Loss: A Pragmatic Trial in an Obesity Clinic
Acosta, Andrés , Camilleri, Michael , Dayyeh, Barham Abu, Mcrae, Alison, Rossini, William, Burton, Duane D. , Clark, Matthew M. , Abu Dayyeh, Barham, Calderon, Gerardo, Burton, Duane, Acosta, Andres , Calderon-Lopez, Gerardo , González, Daniel , Singh, Sneha
Obesity | March 24, 2021 | Volume: 29 | Issue: 4 | Pages: 662-671
ObjectiveLittle is known about the predictors of response to obesity interventions.MethodsIn 450 participants with obesity, body composition, resting energy expenditure, satiety, satiation, eating behavior, affect, and physical activity were measured by validated studies and questionnaires. These variables were used to classify obesity phenotypes. Subsequently, in a 12‐month, pragmatic, real‐world trial performed in a weight management center, 312 patients were randomly assigned to phenotype‐guided treatment or non‐phenotype‐guided treatment with antiobesity medications: phentermine, phentermine/topiramate, bupropion/naltrexone, lorcaserin, and liraglutide. The primary outcome was weight loss at 12 months.ResultsFour phenotypes of obesity were identified in 383 of 450 participants (85%): hungry brain (abnormal satiation), emotional hunger (hedonic eating), hungry gut (abnormal satiety), and slow burn (decreased metabolic rate). In 15% of participants, no phenotype was identified. Two or more phenotypes were identified in 27% of patients. In the pragmatic clinical trial, the phenotype‐guided approach was associated with 1.75‐fold greater weight loss after 12 months with mean weight loss of 15.9% compared with 9.0% in the non‐phenotype‐guided group (difference −6.9% [95% CI −9.4% to −4.5%], P < 0.001), and the proportion of patients who lost >10% at 12 months was 79% in the phenotype‐guided group compared with 34% with non‐phenotype‐guided treatment group.ConclusionsBiological and behavioral phenotypes elucidate human obesity heterogeneity and can be targeted pharmacologically to enhance weight loss.