Craig Primack

Bio: Craig Primack is an academic researcher. The author has contributed to research in topics: Weight Loss Surgery & Diet therapy. The author has an hindex of 1, co-authored 1 publications receiving 6 citations.

A review and critique of published real-world weight management program studies.

Abstract: BACKGROUND Beyond the essential but somewhat artificial conditions that typify formal clinical studies, real-world evidence (RWE) of weight loss program effectiveness is paramount for an accurate assessment of such programs and refinement of best practices. OBJECTIVES To evaluate the current state of RWE studies and publications on weight loss, identify the range of weight loss components being used in RWE programs, and to provide a general overview of the consistency or lack of consistency with regard to measuring and reporting outcomes. METHODS A structured search of PubMed was performed to identify relevant English-language publications from 2006 to December 2017 that reported real-world studies of weight loss among adults. Duplicates, non-relevant publications, articles on weight loss surgery, pediatric studies, randomized controlled trials, studies with self-reported weight loss, no objective weight measures, or that failed to include weight loss results were excluded. RESULTS This review included 62 RWE publications. Forty-nine studies included dietary intervention, 37 included exercise, 29 included motivational counseling, and 5 contained some patients who had pharmacologic treatment as part of their weight loss regimen. The numbers of participants per study ranged from 10 to more than 3 million. The interventions reported in the publications included diet, exercise, counseling to promote diet and/or exercise, motivational counseling, and pharmacotherapy, and various combinations of these. CONCLUSIONS Despite general acceptance that weight loss programs are capable of facilitating successful outcomes, this review revealed substantial inconsistency in the design and reporting of such programs, making it very difficult to draw conclusions about the comparative merits of different real-world weight loss strategies/components. In addition, there was a marked lack of congruence with current weight loss management guidelines, and notably few studies incorporating anti-obesity medications. There clearly is a need for greater rigor and standardization among designing and reporting RWE weight-loss studies.

Effectiveness and tolerability of orlistat and liraglutide in patients with obesity in a real-world setting: The XENSOR Study

Abstract: Aims To evaluate in a real-world setting the effectiveness of two drugs, orlistat and liraglutide, in patients with overweight or obesity and insufficient weight loss (WL) after a lifestyle modification programme. Methods Retrospective, observational cohort study comparing clinical outcomes of orlistat 120 mg three times a day and liraglutide (up to 3 mg daily) in adult patients with BMI ≥30 kg/m2 or ≥27 kg/m2 with at least a weight-related comorbidity who had failed to lose at least 5% of their weight after 6 months of lifestyle modification. The co-primary end-points, assessed at 3-6 months and at the end of the follow-up, were weight change from baseline, proportion of patients who lost at least 5% of their baseline weight and adjusted differences in WL between both drugs. Results Five hundred patients, 400 in the group of orlistat (age 47.0, weight 107.8 kg) and 100 in the group of liraglutide (age 51.9 years, weight 105.1 kg), were included. Treatment with both drugs significantly reduced weight, fasting plasma glucose, systolic BP, low-density lipoprotein-cholesterol and alanine transaminase over a median follow-up period of 7 months. WL with liraglutide (-7.7 kg) was significantly greater than that observed with orlistat (-3.3 kg), and more individuals lost at least 5% of their baseline weight with liraglutide (64.7%) than with orlistat (27.4%). Rates of prediabetes significantly decreased with liraglutide in comparison to orlistat. Conclusions In this real-world study, liraglutide showed a greater effectiveness in WL compared with orlistat and improved several obesity-associated metabolic and cardiovascular risk factors.

Assessment of Nutritional Intakes in Individuals with Obesity under Medical Supervision. A Cross-Sectional Study.

Abstract: People with obesity in Romania are often under medical supervision, which is aimed to decrease body weight and treat accompanying metabolic disorders and cardiovascular implications. However, there is limited information regarding the implementation of dietary recommendations in adults with obesity. We aimed to evaluate the prevalence of reaching the recommended intakes of macro- and micro-nutrients in adults with obesity under medical supervision. Individuals with obesity, recruited in the context of a study with a larger scope (NutriGen ClinicalTrials.gov NCT02837367), who were under medical supervision underwent four 24 h recalls in order to assess daily food intakes. Macro- and micro-nutrient intakes were computed, and the prevalence of reaching recommended dietary allowances (RDAs) for each nutrient was calculated. The majority of subjects did not meet the recommended intakes for most nutrients. Energy from fat exceeded the threshold of 35% recommended intake, even in the lowest quartile of energy intake. The micronutrients with less than 5% of individuals reaching the RDAs were vitamin D, vitamin E, fluoride, and omega-3 fatty acids for both males and females, and choline, magnesium, and potassium in females. The burden of inadequate nutrition in individuals with obesity should be acknowledged and properly addressed within efforts to reduce obesity rates and associated disorders.

Cardiometabolic health, visceral fat and circulating irisin levels: results from a real-world weight loss study

Abstract: The aim of this pragmatic intervention study was to investigate changes in cardiometabolic outcomes, irisin plasma concentration, and body composition during a 4-month intervention in unselected obese individuals. In 111 obese women aged 36.73 ± 7.2 years, we measured changes in weight, lipid profiles, glucose, insulin, Homeostatic Model Assessment-Insulin Resistance Index (HOMA-IR), uric acid, aminotransferases, and irisin. Body composition including lean mass (LM) and total (TF), gynoid (GF), android (AF), and visceral fat (VF) was assessed using densitometry. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ). The participants received tailored written advice targeting lifestyle according to current guidelines. At follow-up, patients rated their adherence in the self-administered questionnaire. Mean weight loss in the whole group was 3.12 kg (− 3.3%); 26% of the women achieved the desired target of weight loss (> 5% of the initial weight), whereas weight decreased moderately in 50% and increased in 14%. In 86 women with weight loss, there were significant changes in HOMA-IR (− 13.8%), insulin (− 11.2%), alanine aminotransferase (− 8.0%), VF (− 7.0%), AF (− 5.4%), TF (− 4.7%), GF (− 2.8%) and LM (− 1.5%), whereas irisin and HDL-C levels and the mean IPAQ score did not change. In this real-world evidence study, a successful weight loss achieved only 26% of patients, with overall much better adherence to diet restriction than to exercise. However, even mild to moderate weight loss resulted in significant improvements in cardiometabolic health. Weight loss was associated with a modest LM decrease but did not influence plasma irisin.

Weight change among repeat participants of an Aboriginal community-based weight loss program

Abstract: Community-based weight loss programs may have potential to address overweight and obesity at the population level However, participation patterns and individual outcomes from these programs are understudied This study examined repeat participation patterns and participant weight change between contests over seven years of an Aboriginal Australian team-based program in order to identify (1) predictors of repeat participation and (2) associations with weight change between contests Data for the 12 contests from 2012 to 2018 were merged, with probabilistic record matching A total of 7510 enrolments were registered for the 12 contests, representing 4438 unique people Contest lengths varied from 10 to 16 weeks in duration Non-repeat participants were those who only competed once in the program by the end of 2018, and repeaters were those who competed in at least two contests Associations between repeat participation and participant baseline (ie, first participation occasion) characteristics, change in diet and physical activity and percent change in weight during the first participation occasion were examined using crossed random effects (for person and team) regression adjusted for exposure to the program Weight percentage change between contests was calculated for consecutive participation occasions occurring at least three months apart, converted to percent change per month Weight change was regressed on number of repeat participation occasions adjusted for age, gender, baseline weight at first participation occasion, and weight percent change in the immediately preceding contest One-third of the 4433 participants participated more than once, with women more likely than men to repeat A 1% reduction in weight during a competition was associated with an increase in weight of 005% per month between competition end and subsequent participation Regain was smaller the heavier participants were at their first participation While individuals benefit from weight loss through program participation, strengthening strategies for weight loss maintenance within or following the program could improve long-term weight outcomes and reduce weight cycling

Depression and Hopelessness as Possible Predictors of Weight Change among Obese Day-Hospital Patients: A 6-Months Follow-Up Study.

Abstract: DEPRESSION AND HOPELESSNESS AS POSSIBLE PREDICTORS OF WEIGHT CHANGE AMONG OBESE DAY-HOSPITAL PATIENTS: A 6-MONTHS FOLLOW-UP STUDY Bjanka Vuksanusa, Nenad Jakši , Martina Matovinovi , Maja Bareti , Zrinka Vuksanusa, Filip Musta , Katarina Ivana Tudor, Marina Šagud & Darko Mar inko Department of Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia School of Medicine, University of Zagreb, Zagreb, Croatia School of Medicine, Josip Juraj Strossmayer University, Osijek, Croatia Division of Endocrinology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb, Croatia Department of Neurology, University Hospital Center Zagreb, Zagreb, Croatia