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Liza Haqq, James McFarlane, Gudrun Dieberg and Neil Smart

final analysis (see consort statement, Fig. 1 ). Figure 1 Consort statement. Data synthesis and outcome measures Our lifestyle intervention groups were defined as exercise-alone or exercise-plus-diet groups. Our definition of usual care (comparator

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Thomas Reinehr, Alexandra Kulle, Juliane Rothermel, Caroline Knop-Schmenn, Nina Lass, Christina Bosse and Paul-Martin Holterhus

using an LC–MS/MS steroid profiling method ( 7 ) in obese adolescent girls with PCOS participating in a lifestyle intervention. Subjects and methods The Local Ethics Committee of the University of Witten/Herdecke approved this study. Written

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Thomas Reinehr, Alberto Sánchez-Guijo, Nina Lass and Stefan A Wudy

normalized hormones like leptin, cortisol or adiponectin ( 6 , 22 , 23 , 24 ). All children participated in the lifestyle intervention ‘Obeldicks’, which has been described in detail elsewhere ( 25 ). Briefly, this outpatient intervention program for

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Anru Wang, Xueqin Yan, Cai Zhang, Caiqi Du, Wenjun Long, Di Zhan and Xiaoping Luo

non-IR group ( n  = 26). Obese children and adolescents whose weight change more than 5% after 6 months of lifestyle intervention were included in subsequent studies. Those individuals treated with medications or weight loss less than 5% were

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Johan Verhelst, Anders F Mattsson, Cecilia Camacho-Hübner, Anton Luger and Roger Abs

normality independently of any condition. The other one, metabolic disruption, could be prevented by timely diagnosis of GHD and treated by adequate GH replacement, but it will also require a lifestyle intervention, physical activity and especially weight

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Alexis Sudlow, Carel W le Roux and Dimitri J Pournaras

Bariatric surgery is established as a highly effective treatment for obesity and related metabolic complications. Although once seen as a last resort for patients with obesity, given the data demonstrating the profound weight loss, improvement in comorbidity and safety, perceptions have since shifted. There is evidence from 12 RCTs demonstrating its safety and efficacy in terms of weight loss which is sustained in the long term with a resultant improvement in co-morbidity. Clinicians are increasingly recognising the importance of timely intervention to maximise the effects of bariatric surgery, particularly in light of the low likelihood of being able to adequately manage patients with medication or lifestyle interventions alone. The inclusion of bariatric surgery in the standard treatment algorithm has been a step forward in the approach to treating patients with obesity. What remains challenging for clinicians is knowing which procedure is most beneficial to patients. There is no level one data demonstrating the superiority of one procedure over another. Head to head RCTs are ongoing which may shed light on this question; however, it is likely that there is no single procedure that will be demonstrated to be the gold standard. Herein we review the most commonly performed procedures along with the evidence available to support their effects with regards to weight loss and metabolic changes along with their limitations and recognised risks. The aim is to provide a general framework to allow clinicians to take advantage of the variety of operative approaches to tailor their treatment strategy to the individual patient.

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Eliana Piantanida, Daniela Gallo, Giovanni Veronesi, Eugenia Dozio, Eugenia Trotti, Adriana Lai, Silvia Ippolito, Jessica Sabatino, Maria Laura Tanda, Antonio Toniolo, Marco Ferrario and Luigi Bartalena

.4 release (SAS Institute Inc., Cary, NC, USA). Results In the study period, a cohort of 196 obese adults (152 women, 51 ± 13 years) fulfilled the inclusion criteria. Fifty-eight percent of patients had never participated in a lifestyle intervention

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Malin Nylander, Signe Frøssing, Caroline Kistorp, Jens Faber and Sven O Skouby

risk of VTE in PCOS. Lifestyle intervention and metformin are mainstays in the treatment of PCOS, aiming at reducing body weight and insulin resistance. In women with PCOS, metformin has been found to reduce PAI-1 activity and levels of hsCRP to a

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Monika Karczewska-Kupczewska, Agnieszka Nikołajuk, Radosław Majewski, Remigiusz Filarski, Magdalena Stefanowicz, Natalia Matulewicz and Marek Strączkowski

their insulin sensitivity after the dietary intervention program. Subjects with lower initial insulin sensitivity achieved greater metabolic benefit from lifestyle intervention ( 29 ). Findings similar to ours regarding worsening ( 29 , 30 ), or the

Open access

Ali Abbasi

Diabetes Prevention Program Research G . Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin . New England Journal of Medicine 2002 346 393 – 403 . ( doi:10.1056/NEJMoa012512 ). 2 Abbasi A Stolk RP Bakker SJ