Introduction: Local profiles on the use of weight loss products are scarce. The study aims to address this together with concerns on the users’ misperception of the safety of these products, and the absence of high-quality evidence to support such use. Methods: This was a cross-sectional study conducted in overweight and obese patients attending a public primary care clinic in Penang. Selected patients were given a set of self-administered questionnaire that assessed types of weight loss products used, factors that influenced the usage and the users’ perception of their own body weight and the diet products they are taking. Results: From 332 participants of this study, 18.7% were users. Mean age of users were 44.6 (SD 11.9) years. The majority (66.1%) only used dietary supplements, 11.3% used weight loss medications and the rest (22.6%) used both products. Reasons for its use were for health, a faster result to lose weight and failing dieting and exercise regimes. The average amount spent on this was RM100 per month. Commonest source of weight loss products were friends. Majority (80.6%) did not discuss the use of the products with doctors. Factors associated with the use of weight loss products were being female (AOR=5.59), had tertiary level education (AOR=2.27), being employed (AOR=3.42), self-perceived of overweight (AOR=3.61) and perception that weight loss products as safe (AOR 2.48). Conclusion: Users of weight loss products are among highly educated working females who perceived themselves as being overweight and assume the products are safe
Diet ; Obesity Management

BACKGROUND: Various methods and equations are available to predict the basal metabolic rate (BMR). A published study comparing the Harris-Benedict Equation, Bioelectrical Impedance Analysis, and Indirect Calorimetry (IC), was done among Filipinos, and was able to obtain a novel formula for BMR. The purpose of this study is to validate this novel formula. METHODS: This is a multi-center, cross-sectional, validation study of the novel BMR equation, done among adult overweight and obese Filipinos, who were seen at St. Luke’s Medical Center and Providence Hospital in Quezon City, Outpatient Clinics from August 2019 to March 2020. Purposive sampling was done, and upon giving consent, subjects had undergone interview, anthropometrics measurement, and IC. RESULTS: 174 samples were enrolled. Mean age is 43 years old, majority are females. 27% have no co-morbidities; of those with co-morbidities, half have diabetes mellitus (DM). Mean weight is 74.30 kg; mean BMI is 29.78 kg/m2 . The mean computed BMR is 1174.70 kcal/day, which is 145.83 significantly lower than the BMR derived with calorimetry: 1320.53 kcal/day (P-value 0.000). However, the scatterplot reveals the linearity of positive direction for both values. 31% of the computed BMR fell within the +/-10% estimate of the actual BMR. Stratification of the results between those with DM and without, lowered the difference between the calculated and actual BMR to 46 kcal/day (from 145.83) among the DM subgroup, and increased the estimated accuracy to 38% falling within the +/- 10% estimate of the actual values. CONCLUSION: The novel BMR formula is linearly reflective of the basal metabolism of adult overweight and obese Filipinos, but the numerical values are lower compared to actual calorimetry results, yielding more accuracy when applied among patients with diabetes.
Calorimetry, Indirect ; Basal Metabolism ; Obesity Management

The excess fatty tissues on the head, neck, thorax, and abdomen of morbid obese patients can impede the patency of the upper airway and impair lung functions. Meanwhile, these patients often have comorbidities such as obstructive sleep apnea, hypoventilation syndrome, chronic obstructive pulmonary disease, and asthma, which may result in difficult airway, intraoperative hypoventilation, and postoperative respiratory depression. Therefore, perioperative airway management for morbid obese patients may pose a big challenge to anesthesiologists. Anesthesiologists should know well about the pathophysiological features of respiratory system and grasp rational management principles, so as to improve the safety and effectiveness of perioperative airway management and optimize the clinical prognosis.
Airway Management ; Anesthesia ; methods ; Humans ; Obesity ; surgery ; Perioperative Care

OBJECTIVES: This study was conducted to investigate the current status and to suggest future directions for health management of teenagers who use healthy school tuck shops to improve teenagers' eating habits while reducing and preventing obesity. METHODS: A total of 29 students (16 middle school students and 13 high school students) took part in the interview for this study, and the interview was conducted for each school's focus group by using qualitative research methodology. RESULTS: The current status of using healthy school tuck shops and suggested future directions were divided into two categories. Personal barriers such as discrepancies between personal perceptions and behaviors and lack of food choice suitable to individual tastes can be solved by rebuilding the operating system to provide intuitive promotion of behavior and customized products through improvements in existing products and new product development. A lack of consistent management from low utilization convenience and difficulty in maintaining a constant purchase price can be handled by establishing a solution to restricted physical access for products, as well as seeking profit by improving distribution costs via continuous cooperation between the school and community. CONCLUSIONS: Continuous funding and a system that reflects the needs and preferences of healthy school tuck shop users should be applied for sustainable operation of healthy school tuck shops to improve teenagers' eating habits.
Adolescent ; Eating ; Financial Management ; Focus Groups ; Humans ; Obesity ; Qualitative Research

OBJECTIVES: This study was conducted to investigate the current status and to suggest future directions for health management of teenagers who use healthy school tuck shops to improve teenagers' eating habits while reducing and preventing obesity. METHODS: A total of 29 students (16 middle school students and 13 high school students) took part in the interview for this study, and the interview was conducted for each school's focus group by using qualitative research methodology. RESULTS: The current status of using healthy school tuck shops and suggested future directions were divided into two categories. Personal barriers such as discrepancies between personal perceptions and behaviors and lack of food choice suitable to individual tastes can be solved by rebuilding the operating system to provide intuitive promotion of behavior and customized products through improvements in existing products and new product development. A lack of consistent management from low utilization convenience and difficulty in maintaining a constant purchase price can be handled by establishing a solution to restricted physical access for products, as well as seeking profit by improving distribution costs via continuous cooperation between the school and community. CONCLUSIONS: Continuous funding and a system that reflects the needs and preferences of healthy school tuck shop users should be applied for sustainable operation of healthy school tuck shops to improve teenagers' eating habits.
Adolescent ; Eating ; Financial Management ; Focus Groups ; Humans ; Obesity ; Qualitative Research

BACKGROUND: It has been recommended that lightwand tracheal intubation be used for cases in which there is difficult airway management. Transillumination of the soft tissue of the neck by the lightwand can lead to successful intubation; however, this depends on skin color, obesity, head position, angle and the bent length of the lightwand. The goal of this study was to compare the success rates of intubation on the first attempt and complications of lightwand orotracheal intubation that occurred when using the lightwand at angles of 60 degrees and 90 degrees. METHODS: One hundred forty eight patients of ASA physical status 1 or 2 were enrolled in this study. Patients in whom intubation had previously been difficult as well as patients who had the potential for difficult intubation were excluded from this study. Patients were randomly assigned to one of two groups: The lightwand bent in 60 degrees (LW60) group and the lightwand bent in 90degrees (LW90) group. Anesthesia was performed using propofol (2 mg/kg), fentanyl (1microg/kg) and rocuronium (0.9 mg/kg), and lightwand orotracheal intubation was attempted 2 minutes after the induction of anesthesia. The success rates of intubation, the number of attempts and their duration, as well as hemodynamic changes, resistance to the tube and complications that occurred during the procedure were recorded. RESULTS: In the LW90 group, resistance to the tube during lightwand intubation occurred in a significant number of patients (P < 0.05), however, there were no significant differences observed between the two groups with regard to the intubation success rates on the first attempt, the duration of intubation, hemodynamic changes and complications. CONCLUSIONS: Their were no significant differences observed between intubation success rates on first attempt and complications when using a lightwand bent to 60 degrees or 90 degrees in patients without any previously known airway abnormalities.
Airway Management ; Anesthesia ; Fentanyl ; Head ; Hemodynamics ; Humans ; Intubation* ; Neck ; Obesity ; Propofol ; Skin ; Transillumination

The purpose of tracheotomy is to obtain secure airway for difficult airway management and long-term lung ventilation. Tracheotomy is an invasive procedure with the possibility of severe complications, but it is the last choice for difficult airway management. To perform tracheotomy is difficult in patients with anatomically distorted trachea, screened trachea by mass, fibrosis or adhesion and obesity. We report the experience of successful tracheotomy in the patient of severely distorted airway due to previous surgeries with the aid of the light illumination of fiberoptic bronchoscope.
Airway Management ; Bronchoscopes* ; Fibrosis ; Humans ; Lighting ; Lung ; Obesity ; Trachea ; Tracheotomy* ; Ventilation

INTRODUCTIONIn Hong Kong, obesity and its associated co-morbidities are increasingly becoming a health and societal burden. Conservative weight management therapy is ineffective in maintaining substantial weight loss in severely obese patients and more invasive interventions are required to achieve sustainable weight loss.

MATERIALS AND METHODSInvasive bariatric procedures were introduced to Hong Kong in 2002. Severely obese patients will be seen in a combined obesity clinic where multi-disciplinary assessment was carried out before interventional therapy. Patients will be allocated to various bariatric surgeries such as laparoscopic adjustable gastric banding (LAGB), laparoscopic sleeve gastrectomy (LSG) or laparoscopic gastric bypass (LGB) when operative criteria were met. For selected patients who were not suitable or refused surgical treatment, endoscopic placement of intragastric balloon (IGB) will be used as an alternative weight control option. Multi-disciplinary approach was also applied during perioperative period to accomplish different clinical needs for the individual patient.

RESULTSOver 500 patients were seen in our unit seeking advice on severe obesity. Two hundred and twenty-five patients received interventional therapy which included LAGB (n = 57), LSG (n = 71), LGB (n = 7) and IGB programme (n = 120). Thirty patients (25%) received second bariatric surgery after IGB removal. Adverse events occurred in 20 patients (7.8%) and there was no operative mortality. At 2 years, the mean percentage of excessive weight loss (%EWL) for LAGB, LSG and LGB are 34%, 51% and 61%, respectively. In those patients who received IGB alone, the mean %EWL at removal and 6 months after removal were 44% and 34%, respectively.

CONCLUSIONSThrough a multi-disciplinary weight management programme with different specialties and various bariatric procedures, favourable results can be achieved in patients with severe obesity.

Adult ; Bariatric Surgery ; Female ; Hong Kong ; Humans ; Male ; Obesity ; surgery ; Patient Care Management ; Patient Care Team

This study was performed to develop a children's dietary life safety index required by the Special Act on Safety Management of Children's Dietary Life enacted in 2009. An analytical hierarchy process was used to obtain initial weights of dietary life safety evaluation indicators. The Delphi method was applied to develop the weights along with 98 food and nutrition professionals. Three representative policy indicators, nine strategy indicators, 11 main evaluation indicators, and 20 detailed evaluation indicators were selected for the children's dietary life safety assessment. Three policy indicators and nine strategy indicators were the following: children's food safety indicator (support level of children' safety, safety management level of children's favorite foods, and safety management level of institutional food service), children's nutrition safety indicator (management level of missing meals and obesity, nutrition management level of children's favorite foods, and nutrition management level of institutional food service), and children's perception and practice level indicator ("Dietary Life Law" perception level, perception, and practice level for dietary life safety management, perception, and practice level for nutrition management). Weights of 40%, 40%, and 20% were given for the three representative policy indicators. The relative importance of nine strategic indicators, which were determined by the Delphi method is as follows: For children's food safety, support level of children's safety, safety management level of children's favorite foods, and safety management level of institutional food service were given weights of 12%, 9%, and 19%, respectively. For children's nutrition safety, the missing meals and obesity management level, nutrition management level of children's favorite foods, and the nutrition management level of institutional food service were given weights of 13%, 11%, and 16%, respectively. The "Dietary Life Law" perception level, perception and practice level of dietary life safety management, and perception and practice level of nutrition management were given weights of 4%, 7%, and 9%, respectively.
Food Safety ; Food Services ; Korea ; Meals ; Obesity ; Safety Management ; Weights and Measures

Increasing rates of obesity are related to increasing incidence of metabolic diseases such as type 2 diabetes, hypertension and cardiovascular disease. The need to prevent and treat obesity is an obvious way to reduce its incidence and to reduce the complications associated with metabolic diseases. To reduce the risk of cardiovascular disease in obese adults, it is important not only to lose weight but to manage preexisting metabolic disease. Therefore, a systematic and organized approach is needed for the management of obesity with metabolic disease.
Adult ; Cardiovascular Diseases ; Disease Management ; Humans ; Hypertension ; Incidence ; Metabolic Diseases ; Obesity*