AUCTORES
Globalize your Research
Review ariticle | DOI: https://doi.org/10.31579/2637-8892/280
Kilis 7 Aralık University, Yusuf Şerefoğlu Faculty of Health Sciences, Obstetrics and Gynecology Nursing.
*Corresponding Author: Özcan Özdemi, Kilis 7 Aralık University, Yusuf Şerefoğlu Faculty of Health Sciences, Obstetrics and Gynecology Nursing, India.
Citation: Seda S. Işik, Seda Sibel Işik, Özcan Özdemi, (2024), An Increasingly Prevalent and Overlooked Issue: The Impact of Obesity on Women's Mental Health, Psychology and Mental Health Care, 8(5): DOI:10.31579/2637-8892/280
Copyright: © 2024, Özcan Özdemi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 10 May 2024 | Accepted: 17 May 2024 | Published: 23 May 2024
Keywords: obesity; women; mental health; nursing
Obesity is becoming an increasingly prevalent public health issue that affects not only physical health but also mental well-being. This article examines the impact of obesity on women's mental health. As part of the research for this review article, electronic databases such as PubMed, PsycINFO, Google Scholar, and ScienceDirect were utilized. In particular, obesity in women is associated with mental health problems such as depression, anxiety, and low self-esteem. The mechanisms underlying this association include social stigma and discrimination, body image issues, and physical health problems. The article addresses the mechanisms of mental health problems caused by obesity, the prevention, treatment, and rehabilitation of the psychosocial problems experienced by obese women, and the interventions that nurses can undertake, based on current scientific studies. It is concluded that the efforts and contributions of nurses in addressing complex health issues such as obesity are critically important for improving patients' quality of life and optimizing treatment outcomes.
Obesity, characterized as chronic, progressive, recurrent, and treatable, is recognized today as a global public health issue. The impact of this health problem on women's mental health is also becoming an increasingly significant area of interest (WHO, 2022; Panuganti et al., 2023). In 2020, over 1.9 billion adults worldwide surpassed the obesity threshold, and by 2025, it is estimated that approximately 2.3 billion individuals globally will be overweight, with 700 million facing obesity. Furthermore, by 2030, it is projected that one billion people, including one in five women and one in seven men globally, will be living with obesity (Boutari et al., 2022). In Turkey, 66.8% of the adult population is classified as overweight, and 32.1% as obese, making it the country with the highest prevalence of obesity in the European Region (WHO, 2022a). These statistics underscore the necessity for sustainable interventions aimed at better understanding and addressing obesity. The underlying factors of obesity are linked to multifactorial phenomena such as economic, social, and physical environmental transformations (Boutari et al., 2022; Nittari et al., 2019; Valencio et al., 2022). The increase in obesity prevalence among women can be attributed to factors such as reduced physical activity with age and increased consumption of high-energy-density foods. These factors are closely related to changes in lifestyle and activity levels (Lash & Armstrong, 2009; Valencio et al., 2022). Additionally, psychological factors can influence eating behaviors; depression, anxiety, and associated feelings of tension can lead to self-deprecation, rejection of body shape, stress, and interpersonal relationship issues (Walker-Clarke et al., 2022). Recently, obesogenic eating behaviors have been linked to hedonic pathways that can override homeostatic mechanisms in the human brain. Although the existence of eating behavior is still debated, it is suggested that there are similar mechanisms between food-triggered hedonic pathways and other addictive substances. It is noted that overweight and obese individuals may derive less pleasure from eating compared to those at an ideal weight and can lose weight when they reduce their food intake. Additionally, after weight loss, hormonal changes can lead to increased hunger as the brain shifts into energy conservation mode, potentially resulting in weight regain (Lee & Dixon, 2017; Finlayson, 2017). Obesity inevitably leads to chronic diseases and complications specific to women's life stages and also affects mental health. In the age of technology and in some societies, the presence of weight-related stigma exacerbates this impact. Stigma creates stress in individuals, laying the groundwork for cognitive, emotional, and behavioral disorders from childhood to adulthood (Cuijpers et al., 2019). The triggering of physiological and behavioral changes by negative emotional experiences strengthens the connection between mental health and obesity (Sattler et al., 2018; Puhl & Suh, 2015). Research shows that the relationship between obesity and mental health often stems from efforts to cope with the negative emotional effects of stress. For example, weight-related stigma is indicated as a factor that triggers mental stress and creates a vicious cycle that promotes weight gain (Tomiyama, 2019; Sattler et al., 2018; Valencio et al., 2022). Epidemiological studies reveal that mental disorders are approximately twice as prevalent in women compared to men, and women are more vulnerable to weight-related stereotypes, making stigma experiences more common among them. This situation negatively impacts women's mental health (Nittari et al., 2019; Sattler et al., 2018; Lash & Armstrong, 2009). Additionally, women are more prone to substance use and risky behaviors, leading to more frequent encounters with conditions such as depression and suicidal ideation (Nittari et al., 2019; Lash & Armstrong, 2009). Besides its adverse effects on reproductive functions, obesity can cause harmful health outcomes and trigger psychological disorders. The rising rates of obesity in recent years have necessitated a closer examination of the mental health impacts of this condition on women (Ng et al., 2014). Numerous studies indicate that obesity is associated with negative health indicators, with obese individuals experiencing higher rates of sleep, circulatory, respiratory, endocrine, and musculoskeletal system diseases (Hauspurg et al., 2019; Van Den Hoek et al., 2023; Maxwell et al., 2023; Valencio et al., 2022). This review systematically examines the effects of obesity on the mental health of women throughout their life cycles, based on literature from Web of Science, PubMed, Scopus, PsycINFO, Google Scholar, and ScienceDirect databases.
Adolescent Period, Obesity, and Mental Health
During adolescence, the influence of estrogen results in a more rapid increase in fat tissue compared to muscle tissue in females. Consequently, females in adolescence tend to be heavier than their male counterparts, making this period particularly risky for obesity (Elliott et al., 2022). According to WHO data from 2022, over 390 million children and adolescents aged 5-19 are classified as overweight (WHO, 2022). Obesity in adolescents is closely linked not only to physical health outcomes but also to psychosocial and mental disorders. Studies have reported that obese adolescents experience issues such as school absenteeism, academic failure, peer bullying, physical abuse, and social isolation. Failures, difficulties in making friends, and low sociability often result in impulsive eating behaviors (Liu et al., 2016). These negative circumstances are noted to lead to similar psychological issues and reduced quality of life in adulthood (Chu et al., 2019).
Weight-based stigma from adolescence to later adulthood is associated with negative emotional outcomes, including low self-esteem, increased anxiety and depression, suicidal ideation, poor body image, eating disorders, and greater overall psychological distress (Puhl & Suh, 2015; Small & Aplasca, 2016). A meta-analysis examining the relationship between obesity and depression in adolescents highlighted the correlation between these two conditions (Mannan et al., 2016). Obese adolescents are more frequently identified with behavioral problems, peer issues, internalized and externalized problems, attention deficit hyperactivity disorder (ADHD), and sleep problems (Schreckenbach et al., 2021; Sönmez et al., 2019; Wang et al., 2019). Studies have found a link between increased body mass index (BMI) and ADHD in adolescents (Işık et al., 2020; Cortese et al., 2016). A study investigating psychiatric disorders in obese adolescents found that specific phobia and social anxiety disorder were more prevalent among obese adolescents compared to their normal-weight peers (Işık et al., 2020). If untreated, these conditions are associated with poor school performance, impaired social functioning, substance abuse, recurrent depression in adulthood, and an increased risk of suicide, which is the second leading cause of preventable death among adolescents (Sutaria et al., 2019). The widespread prevalence of technology addiction in adolescents has also been linked to obesity (Mihrshahi et al., 2017). Some studies suggest that the quality of life in obese girls is lower compared to boys (Ottova et al., 2012; Förster et al., 2023; Mozzillo et al., 2021). The adolescent period, a sensitive time in women's lives, is particularly significant due to the physical and mental health problems caused by obesity. During this period, which emphasizes social interaction, learning, body image, and academic success, adolescent girls with obesity face challenges such as social withdrawal, stigma, bullying, academic failure, and distorted body image. These issues can lead to severe outcomes, including suicide, depression, and addiction (Förster et al., 2023; Mannan et al., 2016; Nittari et al., 2019). In managing and controlling overweight and obesity, it is important to include low-calorie diets, increased physical activity, behavioral changes, and additional psychosocial interventions as preventive measures.
Obesity and Mental Health in Reproductive Age
Obesity can lead to serious health issues for both genders. In particular, obesity in women can significantly increase the risk of various diseases throughout their life stages (Weschenfelder et al., 2018). The World Health Organization (WHO) states that obesity can impact at least seven out of the ten most significant health issues affecting women (WHO, 2015). Obesity in women can increase the risk of breast cancer, cervical cancer, sexual and reproductive health problems, and mental health disorders (Weschenfelder et al., 2018). Recently, the prevalence of obesity has been increasing among women of reproductive age, posing a risk for gynecological problems such as infertility, Polycystic Ovary Syndrome (PCOS), and anovulation. Obesity during pregnancy is a fundamental risk factor for thromboembolism, miscarriages, gestational diabetes, preeclampsia, neonatal deaths, neural tube defects, and depression. Additionally, obesity negatively impacts breastfeeding and contraception processes (Maxwell et al., 2023; Wharton et al., 2020; Yalvaç & Toker, 2021). Moreover, it has been found that obese infertile women experience mental health issues, and their physical quality of life and sexual functions are significantly affected, closely linked to obesity (Karsten et al., 2021). The physical and psychological symptoms associated with obesity are said to be etiologically bidirectional, creating a vicious cycle (Valencio et al., 2022). It is especially emphasized that obesity has a strong relationship with depression, and this relationship appears to be stronger in women than in men. This is thought to be due to societal beauty standards that favor thinness as an ideal for women. Additionally, obese women are more likely to be dissatisfied with their body image and have higher rates of suicidal ideation compared to their normal-weight counterparts (Sarwer & Polonsky, 2016). A study found that obese women are more likely to experience suicidal thoughts, stressful life events, and a higher risk of depression (Engda et al., 2022). Reproductive functions in obese women of reproductive age are also affected, with conditions such as PCOS and infertility negatively impacting their mental health (Karsten et al., 2021). Obesity can also negatively affect women both during and after pregnancy. Research has shown that obese women have higher rates of depression in early pregnancy compared to non-obese women (Ruhstaller et al., 2017). A meta-analysis found that overweight and obese women have higher rates of depression symptoms and prenatal anxiety during pregnancy (Molyneaux et al., 2014). Another noteworthy point is that the mental health issues experienced by obese pregnant women can also affect the fetus (Cattane et al., 2021).
Obesity and Mental Health in Menopause
The menopausal period is a significant phase in women's lives, characterized by an increase in body fat mass. The hormonal and physical changes associated with menopause, along with the use of medications such as antidepressants and hormone therapies to manage these changes, significantly contribute to weight gain (Knight et al., 2021). Weight gain and obesity during menopause can increase the risk of various diseases and exacerbate vasomotor symptoms experienced during this period, thereby adversely affecting women's mental health. In this context, a study found that women with obesity were more likely to experience vasomotor symptoms, sleep problems, anxiety, and depressive symptoms (Blümel et al., 2015). A systematic review conducted on postmenopausal women concluded that obesity is associated with depression, anxiety, and sleep disorders (Abdalla et al., 2022). Another study found that women with higher body mass index (BMI) levels had higher anxiety levels (Barghandan et al., 2021). Despite the increasing interest in studies focusing on obese women during menopause, it is evident that more research is needed. Considering that advancing age, hormonal changes, and obesity after menopause increase the risk of physical disease burden and negatively impact mental health, it is emphasized that calorie restriction, exercise, and interventions to improve mental health are crucial for postmenopausal women.
Nursing in the Mental Health of Obese Women
Nurses play a crucial role in healthcare systems and are essential in supporting both the physical and mental health of individuals. Obesity is a condition that can lead to many comorbid and chronic medical conditions, necessitating a comprehensive approach from nurses in obesity management. Literature indicates that obese women are vulnerable in many physical, psychological, and social aspects throughout their life cycle. It is evident that psychological well-being and mental health are related to improved physical health, mental resilience, and healthy behaviors (Conradson et al., 2022). Obesity requires multifaceted treatment strategies and may need lifelong management. In this context, it is believed that a weight loss of 5% to 10% in obese individuals can significantly improve the health, quality of life, and economic burden of both the individual and the country (Panuganti et al., 2023). Nurses, as healthcare professionals who frequently interact with individuals, can support the strengthening of mental health, improve positive health behaviors, and mitigate the effects of negative self-beliefs and adverse health outcomes in obese women (Jackson et al., 2015). Management strategies can include dietary changes, behavioral interventions, medication, self-care and personal hygiene, surgical intervention when necessary, and psychological care (Panuganti et al., 2023). In the context of obesity and women's mental health, educational and awareness programs conducted by nurses can inform women about the health impacts of obesity and assist in making healthy lifestyle choices (Panuganti et al., 2023). Personalized care plans, considering the individual needs of each patient, provide mental health support. Unrealistic expectations before bariatric surgery and issues such as hair loss, scar tissues, and surgical complications post-surgery can lead to low self-esteem, lack of confidence, and body image disturbance in individuals. A study with surgical nurses indicated that 86% of participants were reluctant to provide care to surgical patients with obesity (Gülay Altun et al., 2017). However, there are studies suggesting that including psychosocial care and psychoeducation in nursing care can lead to effective outcomes in resolving psychosocial problems (Altaheri et al., 2021; Wild et al., 2017). Support group activities (social support networks) can help women share their experiences and reduce feelings of loneliness, contributing to positive mental health outcomes (Lent et al., 2019). The holistic approaches of nurses encompass physical and mental health-inclusive, therapeutic strategies, providing critical support for women in their struggles with obesity and mental health. It is important for nurses to conduct mental state assessments or seek support from consultation-liaison psychiatric nurses to help obese women cope with these health issues (Wild et al., 2017; Panuganti et al., 2023). In our country, psychiatric nurses with therapy competence can engage in various psychotherapeutic interventions, including motivational interviewing, cognitive-behavioral therapy, dialectical behavior therapy, and interpersonal psychotherapy, or provide counseling based on a specific approach. It is also stated that these behavioral interventions, combined with diet and exercise, will be more effective (Oğuz et al., 2016). Raising awareness among women about obesity and implementing nursing approaches that improve mental health can positively affect women and, consequently, represent a significant step towards improving public health.
Obesity continues to be a global public health issue today, leading to negative biopsychosocial health outcomes for women. Throughout the life cycle, from the womb to death, women are affected by gender norms, stigmatization, marginalization, and poor health outcomes, among other factors. The nursing profession, which aims to enhance the quality of life of the community, is deeply concerned with this issue and there is an urgent need for evidence-based interventions. In this context, it is recommended that in primary healthcare services, alongside physical health outcomes, the mental health of obese women should be assessed and monitored, risk factors should be identified, and regional obesity support groups should be established. Furthermore, the inclusion of a mental health specialist and a social worker in interdisciplinary and multidisciplinary teams is anticipated to enhance the adherence of obese women to treatment, and improve the quality of care and the individual's quality of life.
The authors declare that there is no conflict of interest regarding the publication of this paper.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
