Grace O'Malley

Royal College of Surgeons in Ireland | RCSI · Division of Population Health Sciences

Background Ireland’s Model of Care for the Management of Overweight and Obesity outlines a plan for treating adolescent and child obesity (CO). However, engagement with key stakeholders is required to support its implementation and improve health services. Aim This study aims to map the perceived barriers and facilitators related to CO management...

Background: This Clinical Practice Guideline (CPG) for the management of obesity in adults in Ireland, adapted from the Canadian CPG, defines obesity as a complex chronic disease characterised by excess or dysfunctional adiposity that impairs health. The guideline reflects substantial advances in the understanding of the determinants, pathophysiol...

Obesity is a chronic disease that compromises the physical and mental health of an increasing proportion of children globally. In high-income countries, prevalence of paediatric obesity is increasing faster in those from marginalised populations such as low-income households, suggesting the disease as one that is largely systemic. Appropriate treat...

The relationship among the various causal factors of obesity is not well understood, and there remains a lack of viable data to advance integrated, systems models of its etiology. The collection of big data has begun to allow the exploration of causal associations between behavior, built environment, and obesity-relevant health outcomes. Here, we c...

There are disparities in health outcomes between youth from higher and lower socioeconomic backgrounds, and girls are especially vulnerable to changes in health‐related behaviours as they develop. Therefore, this study explored how girls from disadvantaged communities in Dublin, Ireland, make sense of ‘being healthy.’ A phenomenological qualitative...

Introduction Childhood obesity is a chronic disease that requires multidisciplinary and specialist intervention to address its complex pathophysiology, though access to treatment is limited globally. Evaluating the impact of evidence-based interventions implemented in real-world clinical settings is essential, in order to increase the translation o...

Although family-based interventions have been suggested as promising approaches for preventing and treating pediatric obesity, available studies failed to include the whole family in its own natural environment and routine. This paper aims to detail the development, implementation, and evaluation phases of the ProxOb home-based, family-centered pro...

Background Childhood obesity affects around 7–8% of children in Ireland and is associated with increased risks of health complications. Data on healthcare resource use and the related costs for children with obesity are important for research, future service-planning, efforts to reduce the burden on families, and care pathways. However, there is li...

This Review describes current knowledge on the epidemiology and causes of child and adolescent obesity, considerations for assessment, and current management approaches. Before the COVID-19 pandemic, obesity prevalence in children and adolescents had plateaued in many high-income countries despite levels of severe obesity having increased. However,...

Mobile health (mHealth) platforms have become increasingly popular for delivering health interventions in recent years and particularly in light of the COVID-19 pandemic. Childhood obesity treatment is an area where mHealth interventions may be useful due to the multidisciplinary nature of interventions and the need for long-term care. Many mHealth...

Introduction: Since adolescents with obesity are prone to bone fragility during weight loss, the aim was to compare the impact of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) on bone density, geometry, and strength. Methods: Sixty-one adolescents were randomly assigned to 2 cycling trainings (HIIT and...

Background Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarc...

BACKGROUND Mobile health (mHealth) may improve pediatric weight management capacity and the geographical reach of services, and overcome barriers to attending physical appointments using ubiquitous devices such as smartphones and tablets. This field remains an emerging research area with some evidence of its effectiveness; however, there is a scarc...

Background Relationships between the severity of obesity and bone health remain underexplored. Objectives To compare whole-body and localized bone mineral content (BMC) and density (BMD), trabecular bone score (TBS) and hip geometry and strength between adolescents with obesity versus extreme obesity. Methods This cross-sectional study included 1...

Seasonal disease outbreaks are perennial features of human infectious disease but the factors generating these patterns are unclear. Here we investigate seasonal and daytime variability in multiple immune parameters in 329,261 participants in UK Biobank, and test for associations with a wide range of environmental and lifestyle factors, including c...

Background: COVID-19 has brought to the fore an urgent need for secure information and communication technology (ICT) supported healthcare delivery, as the pertinence of infection control and social distancing continues. Telemedicine for paediatric care warrants special consideration around logistics, consent and assent, child welfare and communica...

Background: Multicomponent family interventions underline current best practice in childhood obesity treatment. Mobile health (mHealth) adjuncts that address eating and physical activity behaviors have shown promise in clinical studies. Objective: This study aimed to describe process methods for applying an mHealth intervention to reduce the rate o...

The Milan Charter on Urban Obesity highlights the challenges of urban environments as a battleground for human health, as cities are often organized to subvert public health goals, and promote rather than prevent the development of obesity and consequent non-communicable diseases. The Charter articulates ten principles which detail actions and stra...

Obesity is a major public health problem worldwide and the prevalence of childhood obesity is of particular concern. Effective interventions for preventing and treating childhood obesity aim to change behaviour and exposures at the individual, community, and societal levels. However, monitoring and evaluating such changes is challenging. Developmen...

Background Childhood obesity is influenced by myriad individual, societal and environmental factors that are not typically reflected in current interventions. Socio-ecological conditions evolve and require ongoing monitoring in terms of assessing their influence on child health. The aim of this study was to identify and prioritise indicators deemed...

Background Seasonal disease outbreaks are perennial features of human infectious disease but the factors generating these patterns are unclear. In animal studies, seasonal and circadian (daily) rhythms in immune function generate periodicity in vulnerability to disease, although it is not known whether the same applies to humans. Making use of exte...

The overconsumption of sugar-sweetened beverages (SSBs) is associated with non-communicable diseases such as obesity, type 2 diabetes and cancer. While voluntary industry codes have largely failed to curb the overconsumption of sugar, governments globally are increasingly willing to impose taxes on SSBs. Yet effectiveness of SSB taxation varies sig...

The World Health Organization declared COVID-19, the infectious disease caused by the coronavirus SARS-CoV-2, a pandemic on March 12, 2020. COVID-19 is causing massive health problems and economic suffering around the world. The European Association for the Study of Obesity (EASO) promptly recognised the impact that the outbreak could have on peopl...

Obesity is a complex disease and its prevalence depends on multiple factors related to the local socioeconomic, cultural and urban context of individuals. Many obesity prevention strategies and policies, however, are horizontal measures that do not depend on context-specific evidence. In this paper we present an overview of BigO (http://bigoprogram...

Introduction Smartphone mHealth apps can help children with obesity modify their rate of eating ⁽¹⁾ and monitor physical activity ⁽²⁾ . However, owing to issues with adherence, mHealth interventions require rigorous feasibility testing ⁽³⁾ . Aim To evaluate, using a randomised design, the feasibility and acceptability of a mHealth intervention to...

[Purpose] While there is a need for reliable field tests for the evaluation of physical fitness in pediatric obesity, the present work i) evaluates the validity of the Spartacus 15-15 test in indirectly assessing maximal aerobic capacity in adolescents with obesity and ii) evaluates its sensibility to weight loss. [Participants and Methods] Fifty-f...

BACKGROUND Behaviour change interventions, including diet and physical activity, can significantly improve clinical psychosocial outcomes for children in treatment for obesity. Interventions to address rate of eating, satiety and appetite perceptions have shown promise in eHealth clinical studies. OBJECTIVE To describe process methods for applying...

Background Multicomponent family interventions underline current best practice in childhood obesity treatment. Mobile health (mHealth) adjuncts that address eating and physical activity behaviors have shown promise in clinical studies. Objective This study aimed to describe process methods for applying an mHealth intervention to reduce the rate of...

Background Childhood obesity is stabilising in Ireland, but less so in children from disadvantaged backgrounds. There is also evidence for a relationship between psychosocial difficulties and obesity in youth, but findings are often mixed. This study aimed to describe the relationships between psychosocial difficulties, obesity, and disadvantage in...

Feasibility study to examine the feasibility and acceptability of mHealth interventions in a childhood obesity clinic at tertiary level.

Background: The prevalence and consequences of obesity among children and adolescents remain a leading global public health concern, and evidence-based, multidisciplinary lifestyle interventions are the cornerstone of treatment. Mobile electronic devices are widely used across socioeconomic categories and may provide a means of extending the reach...

BACKGROUND The prevalence and consequences of obesity among children and adolescents remain a leading global public health concern, and evidence-based, multidisciplinary lifestyle interventions are the cornerstone of treatment. Mobile electronic devices are widely used across socioeconomic categories and may provide a means of extending the reach a...

Childhood obesity is a significant public health challenge, yet research priorities for childhood obesity prevention are not established. Coproduction of priorities leads to research which may be more translatable to the domains of policy and practice. The aim of the present study was to identify knowledge gaps and research priorities in addition t...

Illness attributions inform how people understand illness and relate to psychological outcomes. Parental attributions may impact children’s adjustment to illness. This study investigated child, adolescent and parental causal attributions in paediatric obesity and illustrates the relationships between these attributions using network analysis. A cro...

Background: Although multidisciplinary weight management interventions have been shown effective in improving body composition and cardio-respiratory fitness, their effects on HRQOL and perceived health status remain uncertain in adolescents with obesity. Objective: To assess the impact of a 10-month multidisciplinary weight management intervent...

Introduction & Purpose: Childhood obesity is a public health challenge, yet research priorities are not established. Co-production of priorities leads to research which may be more translatable to the domains of policy and practice. The aim of this study was to co-create priorities for childhood obesity prevention research and knowledge about facil...

Background: Childhood obesity is a prominent global health issue yet research priorities are not yet established. Co-production of priorities leads to research which may be more translatable to the domains of policy and practice. The aim of this study was to co-create priorities for childhood obesity prevention research and barriers and facilitator...

Policy Brief to accompany the following article: Hennessy M, Byrne M, Laws R, Mc Sharry J, O’Malley G, Heary C. (2018) Childhood obesity prevention: priority areas for future research and barriers and facilitators to knowledge translation, coproduced using the nominal group technique. Translational Behavioral Medicine. Advance online publication....

To identify and prioritise policy-relevant knowledge gaps for childhood obesity prevention research, by leveraging the collective expertise of a range of stakeholders including national and international researchers, policymakers, and practitioners. Childhood obesity is a prominent global health issue yet research priorities are not yet established...

The aim of this study was to co-create policy-relevant priorities for childhood obesity prevention research using nominal group technique conducted through two-day multi-stakeholder consensus-building workshop hosted during the Association for the Study of Obesity on the island of Ireland’s 2017 conference. Participants contributed, to varying degr...

While obesity mainly results from an imbalance between energy intake and expenditure, physical activity has to be part of prevention and treatment strategies, especially among children and adolescents. Increasing physical activity level mainly depends on the ability to perform exercise, necessitating an objective and accurate evaluation of physical...

Overview of the Irish Research Council-funded project ”POCKETS - Prevention of Obesity in Childhood: Knowledge Exchange and TranSlation”. This project involved the co-creation of research priorities for childhood obesity prevention.

One of the main aims of the European Childhood Obesity Group (ECOG) is to assist healthcare workers in delivering evidence-based assessment and treatment of childhood obesity. Every year the ECOG Congress includes working groups whose objective is to highlight concerns faced by clinicians and practitioners who work in the field of pediatric obesity...

Background: Evaluating physical fitness in obese children is a core element of their clinical management that requires population specific and reliable standards to detect estimates of functional capacity. The aims of the present study were then (i) to estimate the reproducibility of the newly developed Spartacus intermittent run test in adolescen...

The aim of the study was to describe the cardiovascular profile of children referred for obesity treatment The majority of children referred for weight management present with impaired cardiorespiratory fitness. In addition, 55% of participants were defined as hypertensive or pre-hypertensive. It is essential that treatment of children with obesity...

The increasing prevalence of paediatric obesity and related metabolic complications has been mainly associated with lower aerobic fitness while less is known regarding potential musculoskeletal impairments. The purpose of the present systematic review was to report the evidence regarding muscular fitness in children and adolescents with obesity. A...

Childhood obesity is one of the greatest health challenges of the 21st century. The EASO COTF is convinced that classifying obesity as a chronic disease in children and adolescents is a crucial step for increasing individual and societal awareness, and for improving early diagnosis and intervention. Such a classification will enhance the developmen...

Excess body weight composes an important limitation to exercise in obese youth. The aim of this study was to compare the perceived exertion of obese adolescents between weight-bearing (WB; running) and non-weight-Bearing (NWB; cycling) exercises performed at moderate (55%VO2max) and high (75%VO2max) intensities. Twenty-four obese adolescents were r...

Objective While indexes have been proposed to estimate total and abdominal adiposity in adults, the assessment of adiposity among obese adolescents remains difficult in clinical setting. The aim of this study was to evaluate the clinical applicability of total and visceral and fat mass indexes in obese adolescents.Methods One hundred and thirty, 12...

Background: Obesity is a global epidemic. Behavioral change approaches towards improving nutrition, increasing physical activity level, improving sleep, and reducing sitting time are recommended as best practices in adolescent obesity management. However, access to evidence-based treatment is limited and portable technologies such as mobile apps m...

Objective: This paper introduces health professionals to the different psychological models thought to influence eating behaviour in the absence of hunger in children who are obese and to propose a method of assessing these behaviours in practice. Methods: Clinical researchers from the European Childhood Obesity Group (ECOG) adopted an evidence-...

Children who are obese have impaired physical fitness. Balance and coordination are key parameters of fitness and when impaired can lead to falls and musculoskeletal injury. The aim was to investigate whether children who are obese have impaired balance and to explore whether balance impairment is associated with quality of life. Children were recr...

There are few evidence-based mobile health solutions for treating adolescent obesity. The primary aim of this parallel non-inferiority trial is to assess the effectiveness of an experimental smartphone application in reducing obesity at 12 months, compared to the Temple Street W82GO Healthy Lifestyles intervention.Methods/design: The primary outcom...

The objective of this paper is the presentation of obesity-related musculoskeletal problems in childhood while a) focusing on the prevention of anticipated discomforts in adulthood and b) providing information on how best to address such complications in children who are obese. One of the most common problems found in young people is, in particular...

Background/aims: To determine i) whether obesity in childhood can be related to malalignment of the distal extremities, ii) the proportion of genu valgum malalignment and abduction setting, and iii) the respective deviation dominance in children who are morbidly obese. Methods: 31 morbidly obese Caucasian children (16 males) recruited for the ST...

Objective: This paper introduces health professionals to the different psychological models thought to influence eating behaviour in the absence of hunger in children who are obese and to propose a method of assessing these behaviours in practice. Methods: Clinical researchers from the European Childhood Obesity Group (ECOG) adopted an evidence-bas...

: Evidence suggests a negative effect of obesity on musculoskeletal health in children. A pilot study was undertaken to investigate the presence of musculoskeletal impairments in children with obesity and to explore the relationships among body mass index, physical activity, and musculoskeletal measures. : Lower limb musculoskeletal health (pain, p...

Summary of: Davis CL et al (2011) Exercise improves executive function and achievement and alters brain activation in overweight children: a randomized controlled trial. Health Pscyh 30: 91-98. [Prepared by Nora Shields, CAP Editor.] Does aerobic exercise improve cognition and academic achievement in overweight children aged 7-11 years? Randomised,...

Background The aim of the study was to determine neurological and neuropsychiatric manifestations in a group of patients with previously undiagnosed or untreated phenylketonuria (PKU) in the south-eastern part of Poland. Methods The study was conducted among 400 adults with severe intellectual disability who were born prior to neonatal screening an...