Implementing modular competence-oriented psychotherapy in inpatient psychiatry: a three-year analysis of restraint and seclusion.

Obesity represents a rapidly escalating global health crisis, closely associated with an increased risk of numerous chronic conditions such as type 2 diabetes, cardiovascular disease, and certain cancers [, ]. In Sweden, the prevalence has tripled since 1980 and in 2022 more than half of the Swedish population aged 16–84 (52%) were either overweight or obese [, ]. A report from the Swedish capital region of Stockholm showed that obesity was the eighth most commonly recorded chronic diagnosis among individuals who visited the primary care in 2018 []. However, studies suggest that there is an underreporting with less than 40% of all individuals with obesity being diagnosed []. Swedish guidelines for obesity treatment promote a multidisciplinary approach and the interventions include physical activity, dietary changes, behavioural therapy, pharmacological treatment and bariatric surgery []. Lifestyle interventions are the preferred treatment method for mild to moderate forms of obesity, but they have shown to be insufficient in promoting sustainable long-term weight loss results for most patients []. The development of pharmacological treatments of obesity has been full of failures and there are several historical examples of obesity medications being withdrawn from the market after regulatory approval due to safety concerns such as adverse cardiovascular effects, increased suicidal risks, risk for abuse or cancer [, ]. During the last decade, GLP-1 RAs have been approved for obesity treatment since they have been shown to be effective for promoting weight loss in clinical trials [, ]. While previously approved obesity medications were associated with numerous adverse physical and psychological effects, these new agents seem comparatively safe. Systematic reviews have found the most common adverse events to be nausea, vomiting, constipation and diarrhoea, all of which were mild to moderate in severity [, ].