OBJECTIVE: The clinical relevance of the metabolically normal but obese phenotype for mortality risk is unclear. This study examines the risk for all-cause mortality in metabolically normal and abnormal obese (MNOB and MAOB, respectively) individuals. RESEARCH DESIGN AND METHODS: The sample included 6,011 men and women from the Third National Health and Nutrition Examination Survey (NHANES III) with public-access mortality data linkage (follow-up = 8.7 ± 0.2 years; 292 deaths). Metabolically abnormal was defined as insulin resistance (IR) or two or more metabolic syndrome (MetSyn) criteria (excluding waist). RESULTS: A total of 30% of obese subjects had IR, and 38.4% had two or more MetSyn factors, whereas only 6.0% (or 1.6% of the whole population) were free from both IR and all MetSyn factors. By MetSyn factors or IR alone, MNOB subjects (hazard ratio [HR]MetSyn 2.80 [1.18–6.65]; HRIR 2.58 [1.00–6.65]) and MAOB subjects (HRMetSyn 2.74 [1.46–5.15]; HRIR 3.09 [1.55–6.15]) had similar elevations in mortality risk compared with metabolically normal, normal weight subjects. CONCLUSIONS: Although a rare phenotype, obesity, even in the absence of overt metabolic aberrations, is associated with increased all-cause mortality risk.

OBJECTIVE: The metabolic syndrome is a general term given to a clustering of cardiometabolic risk factors that may consist of different phenotype combinations. The purpose of this study was to determine the prevalence of the different combinations of factors that make up the metabolic syndrome as defined by the National Cholesterol Education Program and to examine their association with all-cause mortality in younger and older men and women. RESEARCH DESIGN AND METHODS: A total of 2,784 men and 3,240 women from the Third National Health and Nutrition Examination Survey with public-access mortality data linkage (follow-up = 14.2 ± 0.2 years) were studied. RESULTS: Metabolic syndrome was present in 26% of younger (aged ≤65 years) and 55.0% of older (aged >65 years) participants. The most prevalent metabolic syndrome combination was the clustering of high triglycerides, low HDL cholesterol, and elevated blood pressure in younger men (4.8%) and triglycerides, HDL cholesterol, and elevated waist circumference in younger women (4.2%). The presence of all five metabolic syndrome factors was the most common metabolic syndrome combination in both older men (8.0%) and women (9.2%). Variation existed in how metabolic syndrome combinations were associated with mortality. In younger adults, having all five metabolic syndrome factors was most strongly associated with mortality risk, whereas in older men, none of metabolic syndrome combinations were associated with mortality. In older women, having elevated glucose or low HDL as one of the metabolic syndrome components was most strongly associated with mortality risk. CONCLUSIONS: Metabolic syndrome is a heterogeneous entity with age and sex variation in component clusters that may have important implications for interpreting the association between metabolic syndrome and mortality risk. Thus, metabolic syndrome used as a whole may mask important differences in assessing health and mortality risk.

We sought to determine whether the Edmonton Obesity Staging System (EOSS), a newly proposed tool using obesity-related comorbidities, can help identify obese individuals who are at greater mortality risk. Data from the Aerobics Center Longitudinal Study (n = 29 533) were used to assess mortality risk in obese individuals by EOSS stage (follow-up (SD), 16.2 (7.5) years). The effect of weight history and lifestyle factors on EOSS classification was explored. Obese participants were categorized, using a modified EOSS definition, as stages 0 to 3, based on the severity of their risk profile and conditions (stage 0, no risk factors or comorbidities; stage 1, mild conditions; and stages 2 and 3, moderate to severe conditions). Compared with normal-weight individuals, obese individuals in stage 2 or 3 had a greater risk of all-cause mortality (stage 2 hazards ratio (HR) (95% CI), 1.6 (1.3–2.0); stage 3 HR, 1.7 (1.4–2.0)) and cardiovascular-related mortality (stage 2 HR, 2.1 (1.6–2.8); stage 3 HR. 2.1 (1.6–2.8)). Stage 0/1 was not associated with higher mortality risk. Lower self-ascribed preferred weight, weight at age 21, cardiorespiratory fitness, reported dieting, and fruit and vegetable intake were each associated with an elevated risk for stage 2 or 3. Thus, EOSS offers clinicians a useful approach to identify obese individuals at elevated risk of mortality who may benefit from more attention to weight management. Further research is necessary to determine what EOSS factors are most predictive of mortality risk, and whether these findings can be generalized to other obese populations.

This study aims to look at the prevalence and characteristics of postpartum depression symptomatology (PPDS) among Canadian women. Studies have found that in developed countries, 10-15% of new mothers were affected by major postpartum depression. Mothers who suffer from postpartum depression may endure difficulties regarding their ability to cope with life events, as well as negative clinical implications for maternal-infant attachment.

Summary: To assess the effectiveness of liraglutide 3.0 mg in post‐bariatric surgery patients, and to determine whether this would differ based on the type of bariatric surgery. One hundred seventeen post‐bariatric surgery patients from the Wharton Medical Clinic were analysed. Changes in weight while taking liraglutide 3.0 mg were examined for all patients, and by three types of bariatric surgery—Roux‐en‐Y gastric bypass, gastric banding and gastric sleeve. Patients primarily underwent Roux‐en‐Y gastric bypass (n = 53, 45.3%) or gastric banding (n = 50, 42.7%). Over 7.6 ± 7.1 months taking liraglutide 3.0 mg, patients lost a statistically significant amount of weight (−6.3 ± 7.7 kg, P < .05) regardless of the type of surgery they had (P > .05). This decrease in weight remained significant after 1‐year of taking liraglutide 3.0 mg (P < .05). Nausea was the most prevalent side effect, reported by 29.1% patients. While options for excess weight management in post‐bariatric surgery patients are limited, results of this study suggest that post‐bariatric surgery patients can lose a significant amount of weight while taking liraglutide 3.0 mg regardless of the type of surgery they had. Further, similar to non‐surgical populations, post‐bariatric surgery patients taking liraglutide 3.0 mg may experience gastrointestinal side effects such as nausea and can continue to lose weight up to 1 year.