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This is a clinical trial to determine if 30 sessions of far infrared sauna bathing can improve cardiovascular and metabolic function in adults with obesity.
The goal of this randomized delayed control intervention research study is to see if participants who receive education and healthy prepared meals improve the quality of their diet compared to participants who receive only physical activity education and coaching.
The prevalence of childhood obesity in the United States has more than tripled in the past four decades affecting one in every five adolescent girls and is disproportionally higher among racial and/or ethnic minorities. Normal puberty onset and progression is dependent on normal hypothalamic-pituitary-gonadal (HPG) axis which is affected by whole body metabolism. Gonadotropin-releasing hormone (GnRH) and gonadotropins, LH and FSH, are released in a pulsatile manner for appropriate sex steroids production and gonadal function. Proper pulsatility in the GnRH system is disrupted by a significant change in energy balance such as in obesity. Polycystic Ovary Syndrome (PCOS) is the most common neuroendocrine dysfunction in women of reproductive age. Glucagon-like peptide-1 (GL-1), a peptide hormone secreted by the intestinal enteroendocrine L-cells following glucose and fat intake, stimulates insulin release by the pancreas in response to glucose, decreases gastric emptying and inhibits glucagon secretion. GLP-1 receptors are present in the hypothalamic nuclei and pituitary gland; and it is thought that GLP-1 may directly stimulate GnRH secretion and partially regulate reproduction. In animal studies, GLP-1 was found to stimulate GnRH secretion, to regulate kisspeptin (Kiss-1) mRNA and GnRH mRAN expression. GLP-1 receptor agonists are FDA-approved to treat adults and adolescents with obesity. Although the impact of GLP-1 receptor agonists in reproductive health has been investigated in preclinical trials, and in men with obesity and functional hypogonadism, no studies to date have investigated the impact of GLP-1 receptor agonists in female neuroendocrine function, particularly in youth. The goal of this proposal is to gather critical preliminary data to investigate, in a group of obese adolescent females with PCOS, the impact of GLP-1 agonist administration in addition to lifestyle modifications on the neuroendocrine rhythms - LH frequency and amplitude (principal); body composition, adiposity; and carbohydrate metabolism and insulin sensitivity. To accomplish these aims, we will recruit a cohort of up to 20 adolescents ages 12-18 years, at least 2 years post-menarche, with obesity, PCOS, by NIH criteria, without carbohydrate intolerance and in otherwise good health. Research volunteers will be advised on lifestyle modifications of diet and exercise as per routine, and a GLP-1 agonist will be started according to the product's label as per FDA guidelines in children with obesity. Medication will be titrated to maximal therapeutic dose, as per routine clinical practice. Participants will be treated for a total of 16 weeks. Neuroendocrine rhythms pre- and post-treatment will be compared.
Diabetes represents a significant global health burden, with its prevalence continuously rising and causing extensive impacts on individuals, healthcare systems, and society. The International Diabetes Federation (IDF) Diabetes Atlas 2021 reported a global prevalence of 10.5%, with type 2 diabetes (T2D) comprising approximately 90% of cases. In the US, diabetes prevalence stands at 11.6%, affecting roughly 38.4 million adults, with approximately 1.2 million new diagnoses each year. Obesity, affecting over 42% of US adults-including 9.4% with severe obesity-is recognized as the primary risk factor for diabetes. Severe obesity, present in around 30% of T2D patients, markedly elevates the risk for cardiovascular disease, non-alcoholic fatty liver disease, and other comorbidities, resulting in increased mortality rates. Addressing this burden requires coordinated strategies targeting prevention, early diagnosis, effective treatment, and patient education. However, conventional management methods, such as lifestyle modifications and pharmacotherapy, often result in transient weight loss and temporary diabetes remission, with frequent relapses. In contrast, metabolic surgery, notably Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG), has emerged as a highly effective intervention for significant weight loss and durable diabetes remission, particularly among patients with severe obesity and T2D. These procedures improve metabolic outcomes beyond weight reduction, enhancing insulin sensitivity and glycemic control. Consequently, integrating metabolic surgery into standard diabetes care guidelines and expanding patient access is crucial. Although metabolic surgery outperforms intensive medical therapy, traditional assessment methods, such as HbA1c, have notable limitations. HbA1c measures average glucose levels without capturing short-term fluctuations, glucose variability, or hypoglycemia, limiting its utility post-surgery. Continuous glucose monitoring (CGM) offers real-time, detailed insights into glucose patterns, variability, postprandial excursions, and hypoglycemia, making it highly suitable for postoperative monitoring. CGM provides a clearer picture of immediate and long-term metabolic changes following surgery, allowing early identification of abnormal glycemic patterns influenced by surgical alterations in gastrointestinal anatomy and diet. It enables the detection of post-bariatric hypoglycemia (PBH), a recognized complication following metabolic surgery, and improves understanding of hypoglycemia unawareness-critical for enhancing patient safety and clinical outcomes. However, current research on CGM in metabolic surgery remains limited, primarily consisting of cross-sectional or retrospective studies with small sample sizes, lacking preoperative data, and employing short monitoring periods. Therefore, robust studies such as randomized controlled trials (RCTs) are essential to validate CGM's efficacy and inform its broader adoption in clinical practice.
This research study wants to learn about Chronic Kidney Disease (CKD) with Obesity, and Heart Failure with preserved Ejection Fraction (HFpEF) and better ways to evaluate these diseases. HFpEF means that the heart is not able to fill properly with blood while it is resting so the amount of blood pumped out to the body is less than it would be if it was filling properly. The study is being done to describe the differences in how the kidneys handle protein and salt in participants with HFpEF and obesity compared to healthy persons.
Obesity is a condition affecting one-third off the U.S. population and is a major risk actor for the development of Type 2 diabetes, hyperlipidemia (increased levels of fat in the blood), hypertension (high blood pressure), and other disorders of the heart and lungs. Individuals with the onset of obesity during childhood or adolescence are at an increased risk of obesity-related, diseases, both during adolescence and later in adult life. African American girls and women are at an increased risk for obesity, and have substantial rates of obesity-related diseases and causes of death. Further, many African American adult women fail to respond to many of the therapeutic approaches used to treat obesity. At present there are no medical therapies proven effective for the correction of severe obesity in children or adolescents. One medication that may have a favorable risk-benefit ratio in pediatric populations is Orlistat (Xenical, Hoffmann LaRoche). Orlistat works by preventing the action of enzymes in the digestive process, interfering with the absorption of approximately 1/3 of the fat eaten in the diet. Xenical appears to be effective for reducing weight and obesity-associated diseases in obese adults. Researchers propose to determine the safety, tolerability, and efficacy of Xenical in 12-17 year old severely obese African American and Caucasian children and adolescents who have one or more obesity-related disease (hypertension, hyperlipidemia, sleep apnea, hepatic steatosis, insulin resistance, impaired glucose tolerance, or Type 2 diabetes).
The overall aim of the study is to compare the effects of three types of beverages - sugar-sweetened (SSB), artificially sweetened (ASB), and unsweetened (USB) - on cardiovascular disease (CVD) risk factors and body weight among young adults.
This is a prospective collection of data from adult patients who have had an endoscopic metabolic and bariatric endoscopy procedure (EMBT) for primary or revision surgical procedures for obesity.
The overall objective of this clinical study is to determine the feasibility of breast CT for breast density assessment and association of CT-derived density measures with metabolic syndrome in overweight/obese Mexican-origin women in Southern Arizona. These evaluations will help support follow-up clinical research utilizing breast density acquired by breast CT as a surrogate endpoint biomarker to evaluate breast cancer preventive strategies. The long-term goal of these research efforts is to develop safe and effective preventive strategies to reduce obesity-associated breast cancer burden in our catchment area.
The purpose of this current study is to establish the feasibility of, and preliminary support for, a clinical treatment program utilizing interventions from various empirically supported treatments for obesity-related eating disorders and substance use disorders