Pub Date : 2026-01-12DOI: 10.1016/j.obpill.2026.100247
Jacob E. Earp , Shangshu Zhao , Furong Xu , Chia-Ling Kuo , Jenna M. Bartley , Richard H. Fortinsky , Jatupol Kositsawat , Carlos O. Rehbein , Ellen F. Binder , Jennifer Stevens-Lapsley , George A. Kuchel
Background
With aging and injury, females experience ectopic redistribution of appendicular adipose tissue (AAT) into the visceral compartment, where adipose tissue (VAT) becomes highly inflammatory and increases risk of reinjury and chronic illness. Therefore, strategies that can disrupt this unhealthy adipose redistribution after hip fracture injury are of great interest. We examined the effects of testosterone therapy on total adipose tissue (TAT) and adipose distribution in older females recovering from hip fracture.
Methods
This was a sub-analysis of the STEP-HI study, a multi-site randomized clinical trial in which older females recovering from hip fracture were assigned to a 6-month exercise intervention combined with either topical testosterone gel (EX + T, n = 35, age = 79 ± 9 years) or placebo gel (EX + P, n = 31, age = 76 ± 7 years). Changes in TAT, AAT, and VAT mass and percentage of TAT in each region (%AAT and %VAT) were measured using dual x-ray absorptiometry, and changes over the 6-month intervention were compared between groups.
Results
Over the intervention, changes were similar in TAT (EX + P: 298 ± 2002 g, EX + T: 419 ± 2086 g, p = 0.810), AAT (EX + P: 52 ± 1007 g, EX + T: 39 ± 1078 g, p = 0.810), %AAT (EX + P: 0.42 ± 1.40% of TAT, EX + T: 0.52 ± 1.67% of TAT, p = 0.792) and VAT (EX + P: 45 ± 232 g; EX + T: −44 ± 151 g; p = 0.073). However, relative changes in %VAT from pre-intervention (EX + P: Δ3.51 ± 18.42%; EX + T: −Δ10.57 ± 17.13%; p = 0.004) marked favorable effects of testosterone on relative visceral adiposity.
Conclusion
While testosterone did not decrease overall adipose stores compared to exercise alone in older females recovering from hip fracture, it did promote a healthy pattern of adipose distribution away from the viscera.
Clinical trial #
NCT02938923.
随着年龄的增长和损伤，女性会经历阑尾脂肪组织（AAT）向内脏腔室的异位再分布，在那里脂肪组织（VAT）变得高度炎症，增加再损伤和慢性疾病的风险。因此，能够在髋部骨折损伤后破坏这种不健康脂肪再分配的策略引起了极大的兴趣。我们研究了睾酮治疗对髋部骨折恢复期老年女性总脂肪组织（TAT）和脂肪分布的影响。方法：这是STEP-HI研究的亚分析，STEP-HI是一项多地点随机临床试验，在该试验中，从髋部骨折恢复的老年女性被分配到6个月的运动干预，联合外用睾酮凝胶（EX + T, n = 35，年龄= 79±9岁）或安慰剂凝胶（EX + P, n = 31，年龄= 76±7岁）。使用双x线吸收仪测量TAT、AAT和VAT质量的变化以及每个区域TAT的百分比（%AAT和%VAT），并比较6个月干预期间组间的变化。ResultsOver干预,改变类似答(EX + P: 298±2002 g,例+ T: 419±2086 g, P = 0.810), AAT(例+ P: 52±1007 g,例+ T: 39±1078 g, P = 0.810), % AAT (EX + P: 0.42±1.40%的乙,例+ T:答0.52±1.67%,P = 0.792)和增值税(45例+ P:±232 g;例+ T:−44±151 g; P = 0.073)。然而，与干预前相比，%VAT的相对变化（EX + P： Δ3.51±18.42%;EX + T:−Δ10.57±17.13%;P = 0.004）表明睾酮对相对内脏肥胖有有利作用。结论：与单纯运动相比，睾酮并没有降低髋部骨折后老年女性的整体脂肪储存，但它确实促进了脂肪远离脏器的健康分布模式。临床试验#NCT02938923。
{"title":"Testosterone therapy effects adipose distribution in older females post hip-fracture: The STEP-HI study","authors":"Jacob E. Earp , Shangshu Zhao , Furong Xu , Chia-Ling Kuo , Jenna M. Bartley , Richard H. Fortinsky , Jatupol Kositsawat , Carlos O. Rehbein , Ellen F. Binder , Jennifer Stevens-Lapsley , George A. Kuchel","doi":"10.1016/j.obpill.2026.100247","DOIUrl":"10.1016/j.obpill.2026.100247","url":null,"abstract":"<div><h3>Background</h3><div>With aging and injury, females experience ectopic redistribution of appendicular adipose tissue (AAT) into the visceral compartment, where adipose tissue (VAT) becomes highly inflammatory and increases risk of reinjury and chronic illness. Therefore, strategies that can disrupt this unhealthy adipose redistribution after hip fracture injury are of great interest. We examined the effects of testosterone therapy on total adipose tissue (TAT) and adipose distribution in older females recovering from hip fracture.</div></div><div><h3>Methods</h3><div>This was a sub-analysis of the STEP-HI study, a multi-site randomized clinical trial in which older females recovering from hip fracture were assigned to a 6-month exercise intervention combined with either topical testosterone gel (EX + T, n = 35, age = 79 ± 9 years) or placebo gel (EX + P, n = 31, age = 76 ± 7 years). Changes in TAT, AAT, and VAT mass and percentage of TAT in each region (%AAT and %VAT) were measured using dual x-ray absorptiometry, and changes over the 6-month intervention were compared between groups.</div></div><div><h3>Results</h3><div>Over the intervention, changes were similar in TAT (EX + P: 298 ± 2002 g, EX + T: 419 ± 2086 g, p = 0.810), AAT (EX + P: 52 ± 1007 g, EX + T: 39 ± 1078 g, p = 0.810), %AAT (EX + P: 0.42 ± 1.40% of TAT, EX + T: 0.52 ± 1.67% of TAT, p = 0.792) and VAT (EX + P: 45 ± 232 g; EX + T: −44 ± 151 g; p = 0.073). However, relative changes in %VAT from pre-intervention (EX + P: Δ3.51 ± 18.42%; EX + T: −Δ10.57 ± 17.13%; p = 0.004) marked favorable effects of testosterone on relative visceral adiposity.</div></div><div><h3>Conclusion</h3><div>While testosterone did not decrease overall adipose stores compared to exercise alone in older females recovering from hip fracture, it did promote a healthy pattern of adipose distribution away from the viscera.</div></div><div><h3>Clinical trial #</h3><div>NCT02938923.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1016/j.obpill.2026.100245
James Shand , Yannan Jiang , Rinki Murphy
Background
It is not known how individuals respond to liraglutide or naltrexone/bupropion following low-response to a structured meal replacement low energy diet (MR-LED) programme.
Methods
This was a retrospective observational study conducted at a specialist weight management service using MR-LED with intensive behavioural therapy (IBT). Adults were considered for obesity medication if they did not lose at least 5 % body weight in the first 4 weeks of the intensive MR phase, 10 % after the total 12 week MR phase or regained >4 kg either during the stepped food reintroduction or weight maintenance phases. Eligible individuals were offered liraglutide 3.0 mg (LIRA) or naltrexone/bupropion (NB32) for 13 weeks (including dose titration). The primary outcome was the proportion of individuals achieving ≥5 % weight reduction after 13 weeks of treatment. Completers were defined as those who had a body weight measured between 10 and 16 weeks and did not discontinue the medication before this period.
Results
Of 114 people offered obesity medications, 85 accepted (67 LIRA, 18 NB32). 46 individuals completed 13 weeks’ treatment and 11 (24 %) achieved ≥5 % weight reduction. Among completers (54 %), the mean weight change was −4.4 kg (−2.4 %), and was −2.7 kg (−1.5 %) for the total treated cohort using last weight carried forward on missing data. Those achieving ≥5 % weight reduction were more likely to be male and had lower prevalence of diabetes, binge eating, anxiety or depressive symptoms at baseline.
Conclusion
People who do not respond to a MR-LED with IBT have lower than anticipated weight reduction on subsequent treatment with first-generation obesity medications.
{"title":"Outcomes of obesity medications in those with low response to a low-energy diet meal replacement programme: An observational study","authors":"James Shand , Yannan Jiang , Rinki Murphy","doi":"10.1016/j.obpill.2026.100245","DOIUrl":"10.1016/j.obpill.2026.100245","url":null,"abstract":"<div><h3>Background</h3><div>It is not known how individuals respond to liraglutide or naltrexone/bupropion following low-response to a structured meal replacement low energy diet (MR-LED) programme.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study conducted at a specialist weight management service using MR-LED with intensive behavioural therapy (IBT). Adults were considered for obesity medication if they did not lose at least 5 % body weight in the first 4 weeks of the intensive MR phase, 10 % after the total 12 week MR phase or regained >4 kg either during the stepped food reintroduction or weight maintenance phases. Eligible individuals were offered liraglutide 3.0 mg (LIRA) or naltrexone/bupropion (NB32) for 13 weeks (including dose titration). The primary outcome was the proportion of individuals achieving ≥5 % weight reduction after 13 weeks of treatment. Completers were defined as those who had a body weight measured between 10 and 16 weeks and did not discontinue the medication before this period.</div></div><div><h3>Results</h3><div>Of 114 people offered obesity medications, 85 accepted (67 LIRA, 18 NB32). 46 individuals completed 13 weeks’ treatment and 11 (24 %) achieved ≥5 % weight reduction. Among completers (54 %), the mean weight change was −4.4 kg (−2.4 %), and was −2.7 kg (−1.5 %) for the total treated cohort using last weight carried forward on missing data. Those achieving ≥5 % weight reduction were more likely to be male and had lower prevalence of diabetes, binge eating, anxiety or depressive symptoms at baseline.</div></div><div><h3>Conclusion</h3><div>People who do not respond to a MR-LED with IBT have lower than anticipated weight reduction on subsequent treatment with first-generation obesity medications.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-23DOI: 10.1016/j.obpill.2025.100244
Harold Edward Bays
{"title":"New era in obesity medication access: A commentary","authors":"Harold Edward Bays","doi":"10.1016/j.obpill.2025.100244","DOIUrl":"10.1016/j.obpill.2025.100244","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100244"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-16DOI: 10.1016/j.obpill.2025.100243
María José Ayora- Pérez , Eduardo Andrés Román Cataña , Bernarda Patiño-Araujo , María Emilia Salgado-Báez , Gabriel Patricio Villavicencio-Logroño , Gabriela Zapata-Jaramillo , Napoleón Salgado-Macías
Introduction
Obesity in patients with type 1 diabetes mellitus (T1DM) and kidney disease presents unique challenges, particularly after transplantation, where weight gain can compromise graft function and metabolic control. Bariatric surgery has emerged as a therapeutic option in transplant recipients with obesity, though its role in T1DM remains less explored.
Main concerns and clinical finings
We report the case of a 45-year-old man with longstanding T1DM complicated by hypertension, diabetic retinopathy, and end-stage renal disease, who underwent a deceased-donor kidney transplant at age 40. Post-transplant, he developed type III obesity (BMI 44.5 kg/m2), poor glycemic control (HbA1c 9.8 %), and severe hepatic steatosis despite intensive medical therapy.
Intervention
Laparoscopic sleeve gastrectomy was performed without intraoperative complications (operative time 70 minutes, specimen weight 100 g, minimal blood loss). The postoperative course was notable only for a transient ileus requiring two days of hospitalization. At follow-up, the patient demonstrated significant weight loss, resolution of albuminuria, improved glycemic stability with marked reduction in insulin requirements, and improvement of hepatic steatosis. Importantly, immunosuppressant drug levels consistently remained within therapeutic range throughout follow-up.
Conclusion
This case highlights the safety and efficacy of sleeve gastrectomy in a kidney transplant recipient with longstanding T1DM, resulting in significant metabolic, renal, and hepatic improvements without compromising graft function or immunosuppressive therapy. To our knowledge, this is the first reported case of sleeve gastrectomy in a patient with T1DM following kidney transplantation, underscoring its feasibility and the need for further research in this complex population.
{"title":"Laparoscopic sleeve gastrectomy in a patient with type 1 diabetes and kidney transplant: A case report","authors":"María José Ayora- Pérez , Eduardo Andrés Román Cataña , Bernarda Patiño-Araujo , María Emilia Salgado-Báez , Gabriel Patricio Villavicencio-Logroño , Gabriela Zapata-Jaramillo , Napoleón Salgado-Macías","doi":"10.1016/j.obpill.2025.100243","DOIUrl":"10.1016/j.obpill.2025.100243","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity in patients with type 1 diabetes mellitus (T1DM) and kidney disease presents unique challenges, particularly after transplantation, where weight gain can compromise graft function and metabolic control. Bariatric surgery has emerged as a therapeutic option in transplant recipients with obesity, though its role in T1DM remains less explored.</div></div><div><h3>Main concerns and clinical finings</h3><div>We report the case of a 45-year-old man with longstanding T1DM complicated by hypertension, diabetic retinopathy, and end-stage renal disease, who underwent a deceased-donor kidney transplant at age 40. Post-transplant, he developed type III obesity (BMI 44.5 kg/m<sup>2</sup>), poor glycemic control (HbA1c 9.8 %), and severe hepatic steatosis despite intensive medical therapy.</div></div><div><h3>Intervention</h3><div>Laparoscopic sleeve gastrectomy was performed without intraoperative complications (operative time 70 minutes, specimen weight 100 g, minimal blood loss). The postoperative course was notable only for a transient ileus requiring two days of hospitalization. At follow-up, the patient demonstrated significant weight loss, resolution of albuminuria, improved glycemic stability with marked reduction in insulin requirements, and improvement of hepatic steatosis. Importantly, immunosuppressant drug levels consistently remained within therapeutic range throughout follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlights the safety and efficacy of sleeve gastrectomy in a kidney transplant recipient with longstanding T1DM, resulting in significant metabolic, renal, and hepatic improvements without compromising graft function or immunosuppressive therapy. To our knowledge, this is the first reported case of sleeve gastrectomy in a patient with T1DM following kidney transplantation, underscoring its feasibility and the need for further research in this complex population.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100243"},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-09DOI: 10.1016/j.obpill.2025.100242
Marisa Censani , Angela Fitch , Carolynn Starr Francavilla Brown , Harold Edward Bays
{"title":"Obesity Medicine Association (OMA) Position Statement on Medicare and Medicaid coverage and expanded access to obesity medications: Preliminary perspective 2025","authors":"Marisa Censani , Angela Fitch , Carolynn Starr Francavilla Brown , Harold Edward Bays","doi":"10.1016/j.obpill.2025.100242","DOIUrl":"10.1016/j.obpill.2025.100242","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100242"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.obpill.2025.100240
Ole Schmiedel , Melissa Ivey , Nishi Karunasinghe , Rinki Murphy
Background
Despite the availability of different obesity medications, individual responses vary widely. This pilot study evaluated whether the New Zealand Eating Behavior Questionnaire (NZ-EBQ) could predict weight loss response to naltrexone/bupropion in adults with clinical obesity.
Methods
We conducted a 24-week prospective, single-site, pilot, exploratory, phenotype-stratified trial evaluating utility of the NZ-EBQ for predicting weight reduction response to naltrexone/bupropion. Prior to enrolment, participants completed the NZ-EBQ, which classified their eating behavior phenotype and hypothesized congruence or incongruence with treatment allocation. The primary outcomes were changes in body weight and body mass index (BMI) at 12 and 24 weeks between emotional eaters and other phenotypes (reduced satiety or satiation) tested using independent t-tests and linear regression (significance threshold p < 0.10).
Results
Of 67 participants enrolled, 44 (65.7 %) completed 12 weeks and 37 (55.2 %) completed 24 weeks. Median baseline weight was 133.1 kg (IQR: 111.6–151.7). At 24 weeks, mean weight loss was 4.54 % (95 % CI: 2.83–6.25 %). Participants with emotional eating lost significantly more weight (6.44 %, 95 % CI: 3.64–9.24) than those with reduced satiation (4.69 %, 95 % CI: 0.23–9.15) or reduced satiety (2.82 %, 95 % CI: 0.33–5.30). In multiple linear regression analysis, primary eating behavior trait score and family history of obesity were significant predictors of weight loss (B = 16.8, SE = 10.9, p = .13, 95 % CI: 5.59 – 39.15). The safety profile, including rate of withdrawal and treatment-related adverse events, was consistent with results reported in pivotal studies with naltrexone/bupropion.
Conclusion
These findings suggest that participants with emotional eating lost more weight after naltrexone/bupropion than those with other eating behavior phenotypes identified using the NZ-EBQ. Further trials are warranted to validate these preliminary results.
Australia and New Zealand Clinical Trials Registry (ACTRN12622000703707).
尽管有不同的肥胖药物，但个体的反应差异很大。这项初步研究评估了新西兰饮食行为问卷（NZ-EBQ）是否可以预测临床肥胖成人对纳曲酮/安非他酮的减肥反应。方法：我们进行了一项为期24周的前瞻性、单站点、试点、探索性、表型分层试验，评估NZ-EBQ在预测纳曲酮/安非他酮减肥反应中的效用。在入组之前，参与者完成了NZ-EBQ，对他们的饮食行为表型进行分类，并假设与治疗分配一致或不一致。主要结局是情绪性进食者和其他表型（饱腹感或饱腹感减少）在12周和24周时体重和体重指数（BMI）的变化，使用独立t检验和线性回归（显著性阈值p <； 0.10）进行检验。在67名受试者中，44名（65.7%）完成了12周治疗，37名（55.2%）完成了24周治疗。中位基线体重为133.1 kg （IQR: 111.6-151.7）。24周时，平均体重减轻4.54% （95% CI: 2.83 - 6.25%）。情绪进食的参与者比那些减少饱腹感的参与者（4.69%,95% CI: 0.23-9.15）或减少饱腹感的参与者（2.82%,95% CI: 0.33-5.30）减掉了更多的体重（6.44%,95% CI: 3.64-9.24）。多元线性回归分析中，主要饮食行为特征评分和肥胖家族史是体重减轻的显著预测因子（B = 16.8, SE = 10.9, p = 0.13, 95% CI: 5.59 ~ 39.15）。安全性，包括停药率和治疗相关不良事件，与纳曲酮/安非他酮关键性研究报告的结果一致。结论情绪性进食的受试者在服用纳曲酮/安非他酮后比其他进食行为表型的受试者体重减轻更多。需要进一步的试验来验证这些初步结果。澳大利亚和新西兰临床试验注册中心（ACTRN12622000703707）。
{"title":"Applicability of the New Zealand-eating behavior questionnaire to predict weight loss responses to naltrexone/bupropion: a proof-of-concept trial","authors":"Ole Schmiedel , Melissa Ivey , Nishi Karunasinghe , Rinki Murphy","doi":"10.1016/j.obpill.2025.100240","DOIUrl":"10.1016/j.obpill.2025.100240","url":null,"abstract":"<div><h3>Background</h3><div>Despite the availability of different obesity medications, individual responses vary widely. This pilot study evaluated whether the New Zealand Eating Behavior Questionnaire (NZ-EBQ) could predict weight loss response to naltrexone/bupropion in adults with clinical obesity.</div></div><div><h3>Methods</h3><div>We conducted a 24-week prospective, single-site, pilot, exploratory, phenotype-stratified trial evaluating utility of the NZ-EBQ for predicting weight reduction response to naltrexone/bupropion. Prior to enrolment, participants completed the NZ-EBQ, which classified their eating behavior phenotype and hypothesized congruence or incongruence with treatment allocation. The primary outcomes were changes in body weight and body mass index (BMI) at 12 and 24 weeks between emotional eaters and other phenotypes (reduced satiety or satiation) tested using independent t-tests and linear regression (significance threshold p < 0.10).</div></div><div><h3>Results</h3><div>Of 67 participants enrolled, 44 (65.7 %) completed 12 weeks and 37 (55.2 %) completed 24 weeks. Median baseline weight was 133.1 kg (IQR: 111.6–151.7). At 24 weeks, mean weight loss was 4.54 % (95 % CI: 2.83–6.25 %). Participants with emotional eating lost significantly more weight (6.44 %, 95 % CI: 3.64–9.24) than those with reduced satiation (4.69 %, 95 % CI: 0.23–9.15) or reduced satiety (2.82 %, 95 % CI: 0.33–5.30). In multiple linear regression analysis, primary eating behavior trait score and family history of obesity were significant predictors of weight loss (B = 16.8, SE = 10.9, p = .13, 95 % CI: 5.59 – 39.15). The safety profile, including rate of withdrawal and treatment-related adverse events, was consistent with results reported in pivotal studies with naltrexone/bupropion.</div></div><div><h3>Conclusion</h3><div>These findings suggest that participants with emotional eating lost more weight after naltrexone/bupropion than those with other eating behavior phenotypes identified using the NZ-EBQ. Further trials are warranted to validate these preliminary results.</div><div>Australia and New Zealand Clinical Trials Registry (ACTRN12622000703707).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.obpill.2025.100241
Mona Joumaa , Madeeha Kalsekar , Momina Malik , Fatemeh Akbarpoor , Dana Abdelrahim , Sara El Ghandour
Background
A modest weight loss of ≥5 % among patients with obesity is associated with a reduced risk of type 2 diabetes, hypertension, and other obesity-related complications. Dietary interventions play a central role in obesity management and improving metabolic health, yet region-specific data from the United Arab Emirates (UAE) remains limited.
Methods
This retrospective chart review aims to assess effectiveness of dietary intervention on weight loss outcomes in patients with overweight and obesity attending a Center of Excellence for Weight Reduction and Obesity Management in UAE. This study included adult patients with BMI ≥25 kg/m2 who received individualized dietary counseling between September 2018 and September 2021. Patients who had undergone bariatric procedures or on obesity medications were excluded. Anthropometric and body composition data were collected before and after intervention. Outcomes included changes in weight, BMI, fat mass, visceral fat, and other metabolic parameters. Statistical analyses included paired t-tests, correlation coefficients, and multivariate regression to assess associations between intervention frequency, duration, and weight-related outcomes.
Results
A total of 266 patients (mean age 44.46 ± 8.18 years; 63.9 % female) were included. Following the intervention, participants achieved significant mean weight loss of 5.12 % (p < 0.001), with corresponding reductions in BMI (4.93 %, p < 0.001), fat mass (10.11 %, p < 0.001), and visceral fat (34.34 %, p = 0.014). More frequent sessions and longer follow-up durations were significantly associated with greater improvements in BMI, fat mass, and fat percentage. Gender-based analysis revealed that males experienced greater reductions in fat mass and resting energy expenditure compared to females.
Conclusion
The dietary intervention resulted in significant improvements in anthropometric and body composition indices. These findings support the efficacy of individualized, dietitian-led interventions in managing obesity. The observed gender differences highlight the importance of tailored approaches in obesity care. This study contributes to the limited body of evidence on effective, non-pharmacological obesity management strategies in UAE.
{"title":"Reporting the effectiveness of dietary intervention on weight loss outcomes in patients with obesity and overweight: a retrospective chart review at a Center of Excellence in UAE","authors":"Mona Joumaa , Madeeha Kalsekar , Momina Malik , Fatemeh Akbarpoor , Dana Abdelrahim , Sara El Ghandour","doi":"10.1016/j.obpill.2025.100241","DOIUrl":"10.1016/j.obpill.2025.100241","url":null,"abstract":"<div><h3>Background</h3><div>A modest weight loss of ≥5 % among patients with obesity is associated with a reduced risk of type 2 diabetes, hypertension, and other obesity-related complications. Dietary interventions play a central role in obesity management and improving metabolic health, yet region-specific data from the United Arab Emirates (UAE) remains limited.</div></div><div><h3>Methods</h3><div>This retrospective chart review aims to assess effectiveness of dietary intervention on weight loss outcomes in patients with overweight and obesity attending a Center of Excellence for Weight Reduction and Obesity Management in UAE. This study included adult patients with BMI ≥25 kg/m<sup>2</sup> who received individualized dietary counseling between September 2018 and September 2021. Patients who had undergone bariatric procedures or on obesity medications were excluded. Anthropometric and body composition data were collected before and after intervention. Outcomes included changes in weight, BMI, fat mass, visceral fat, and other metabolic parameters. Statistical analyses included paired t-tests, correlation coefficients, and multivariate regression to assess associations between intervention frequency, duration, and weight-related outcomes.</div></div><div><h3>Results</h3><div>A total of 266 patients (mean age 44.46 ± 8.18 years; 63.9 % female) were included. Following the intervention, participants achieved significant mean weight loss of 5.12 % (p < 0.001), with corresponding reductions in BMI (4.93 %, p < 0.001), fat mass (10.11 %, p < 0.001), and visceral fat (34.34 %, p = 0.014). More frequent sessions and longer follow-up durations were significantly associated with greater improvements in BMI, fat mass, and fat percentage. Gender-based analysis revealed that males experienced greater reductions in fat mass and resting energy expenditure compared to females.</div></div><div><h3>Conclusion</h3><div>The dietary intervention resulted in significant improvements in anthropometric and body composition indices. These findings support the efficacy of individualized, dietitian-led interventions in managing obesity. The observed gender differences highlight the importance of tailored approaches in obesity care. This study contributes to the limited body of evidence on effective, non-pharmacological obesity management strategies in UAE.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145747898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.obpill.2025.100239
John T. Stutts , Yong S. Choe , Ashley Lynn Bronston
Background
Adolescence is a critical period of growth with elevated nutritional demands, yet many U.S. adolescents fail to meet recommended dietary intakes. This study analyzed data from three NHANES cycles (2013–2018) to assess obesity trends among adolescents aged 12–18, compare dietary intake by BMI, and evaluate nutritional biomarkers.
Methods
This retrospective observational study analyzed data from three NHANES cycles to estimate obesity prevalence among U.S. adolescents aged 12–18 years. Dietary intake and blood concentrations of micro- and macronutrients were compared between adolescents with and without obesity. Obesity was defined as BMI ≥95th percentile per CDC growth charts. Nutrient intake was assessed against Estimated Average Requirement (EAR) and Adequate Intake (AI) benchmarks, and biomarker levels were evaluated using established clinical thresholds. All statistical analyses were conducted using SAS version 9.4 and SAS Enterprise Guide version 8.3.
Results
Obesity prevalence increased slightly from 20.3% to 21.3% across cycles. Among all dietary intake variables analyzed, only one demonstrated a statistically significant difference between those with obesity and those without. The adolescents with obesity were significantly more likely to have protein intakes below the EAR (50.3% vs. 22.9%, P < 0.001). Over half of all adolescents failed to meet recommended intake levels for several nutrients, regardless of their BMI categories. The blood biomarker analysis revealed significantly lower levels of vitamin D, vitamin C, serum iron, albumin, and MCV in those with obesity, alongside higher levels of total protein, globulin, and hs-CRP (P ≤ 0.05). The prevalence of low vitamin D, low hemoglobin, low MCV, and iron deficiency anemia was also significantly higher in the group with obesity.
Conclusions
This study reveals that despite similar caloric intakes, adolescents with obesity exhibited higher rates of nutrient deficiencies and markers of inflammation. This work underscores the importance of recognizing nutrition gaps in adolescent care.
{"title":"Adolescent obesity: Biochemical and dietary disparities in U.S. youth","authors":"John T. Stutts , Yong S. Choe , Ashley Lynn Bronston","doi":"10.1016/j.obpill.2025.100239","DOIUrl":"10.1016/j.obpill.2025.100239","url":null,"abstract":"<div><h3>Background</h3><div>Adolescence is a critical period of growth with elevated nutritional demands, yet many U.S. adolescents fail to meet recommended dietary intakes. This study analyzed data from three NHANES cycles (2013–2018) to assess obesity trends among adolescents aged 12–18, compare dietary intake by BMI, and evaluate nutritional biomarkers.</div></div><div><h3>Methods</h3><div>This retrospective observational study analyzed data from three NHANES cycles to estimate obesity prevalence among U.S. adolescents aged 12–18 years. Dietary intake and blood concentrations of micro- and macronutrients were compared between adolescents with and without obesity. Obesity was defined as BMI ≥95th percentile per CDC growth charts. Nutrient intake was assessed against Estimated Average Requirement (EAR) and Adequate Intake (AI) benchmarks, and biomarker levels were evaluated using established clinical thresholds. All statistical analyses were conducted using SAS version 9.4 and SAS Enterprise Guide version 8.3.</div></div><div><h3>Results</h3><div>Obesity prevalence increased slightly from 20.3% to 21.3% across cycles. Among all dietary intake variables analyzed, only one demonstrated a statistically significant difference between those with obesity and those without. The adolescents with obesity were significantly more likely to have protein intakes below the EAR (50.3% vs. 22.9%, <em>P</em> < 0.001). Over half of all adolescents failed to meet recommended intake levels for several nutrients, regardless of their BMI categories. The blood biomarker analysis revealed significantly lower levels of vitamin D, vitamin C, serum iron, albumin, and MCV in those with obesity, alongside higher levels of total protein, globulin, and hs-CRP (<em>P</em> ≤ 0.05). The prevalence of low vitamin D, low hemoglobin, low MCV, and iron deficiency anemia was also significantly higher in the group with obesity.</div></div><div><h3>Conclusions</h3><div>This study reveals that despite similar caloric intakes, adolescents with obesity exhibited higher rates of nutrient deficiencies and markers of inflammation. This work underscores the importance of recognizing nutrition gaps in adolescent care.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100239"},"PeriodicalIF":0.0,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-29DOI: 10.1016/j.obpill.2025.100236
Jessica Duncan, Patrick Lee Stevens, Emily Bigby, Courtney Floyd, Josh Malina, Jennifer Nickens, Amber Lambert, Taylor Kantor
Introduction
Obesity and its downstream effects continue to drive rising rates of chronic disease. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has shown significant potential in supporting weight loss and improving metabolic health. This study examines the use of tirzepatide alongside the Individualized Virtual Integrative Medicine (IVIM) protocol. This is a telehealth-based approach to improving outcomes through consistent access to care and support throughout the weight reduction journey.
Methods
This is a retrospective analysis of 1166 patients who completed at least 52-weeks of the IVIM clinical protocol while on GLP-1 therapy with tirzepatide overseen by a team of board-certified obesity medicine physicians and nurse practitioners. Only patients with a body mass index (BMI) of 30 or greater were included. Due to the branded tirzepatide shortage, patients were provided with the ability to utilize compounded tirzepatide medications, if medically appropriate.
Results
Mean change at 12-weeks for patients both on compounded tirzepatide and branded tirzepatide was −20.12 lbs (−8.80 %), 24-weeks: −35.67 lbs (−15.72 %), 36-weeks: −47.33 lbs (−20.34 %), 52-weeks: −52.28 lbs (−22.74 %). At 72 weeks of therapy, patients had lost an average of −62.79 lbs (−26.54 %). The percentage of patients who lost at least 5 % of their body weight at 52 weeks was: 99.36 %, 10 % or more: 97.12 %, 15 % or more: 84.66 %, 20 % or more: 64.22 %, and 25 % or more: 41.21 %.
Discussion
Patients completing 52-weeks of tirzepatide therapy on the IVIM protocol experienced significant weight loss with a high level of treatment adherence and program utilization. The findings suggest that individualized dose titration and frequent access to support may improve outcomes of patients initiated on weight reduction therapy with GLP-1 medications. These findings support the IVIM protocol as a safe, effective and individualized model for delivering obesity treatment through a curated, patient-centered, virtual approach.
{"title":"Weight reduction and treatment adherence with tirzepatide using the Individualized Virtual Integrative Medicine (IVIM) protocol","authors":"Jessica Duncan, Patrick Lee Stevens, Emily Bigby, Courtney Floyd, Josh Malina, Jennifer Nickens, Amber Lambert, Taylor Kantor","doi":"10.1016/j.obpill.2025.100236","DOIUrl":"10.1016/j.obpill.2025.100236","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity and its downstream effects continue to drive rising rates of chronic disease. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has shown significant potential in supporting weight loss and improving metabolic health. This study examines the use of tirzepatide alongside the Individualized Virtual Integrative Medicine (IVIM) protocol. This is a telehealth-based approach to improving outcomes through consistent access to care and support throughout the weight reduction journey.</div></div><div><h3>Methods</h3><div>This is a retrospective analysis of 1166 patients who completed at least 52-weeks of the IVIM clinical protocol while on GLP-1 therapy with tirzepatide overseen by a team of board-certified obesity medicine physicians and nurse practitioners. Only patients with a body mass index (BMI) of 30 or greater were included. Due to the branded tirzepatide shortage, patients were provided with the ability to utilize compounded tirzepatide medications, if medically appropriate.</div></div><div><h3>Results</h3><div>Mean change at 12-weeks for patients both on compounded tirzepatide and branded tirzepatide was −20.12 lbs (−8.80 %), 24-weeks: −35.67 lbs (−15.72 %), 36-weeks: −47.33 lbs (−20.34 %), 52-weeks: −52.28 lbs (−22.74 %). At 72 weeks of therapy, patients had lost an average of −62.79 lbs (−26.54 %). The percentage of patients who lost at least 5 % of their body weight at 52 weeks was: 99.36 %, 10 % or more: 97.12 %, 15 % or more: 84.66 %, 20 % or more: 64.22 %, and 25 % or more: 41.21 %.</div></div><div><h3>Discussion</h3><div>Patients completing 52-weeks of tirzepatide therapy on the IVIM protocol experienced significant weight loss with a high level of treatment adherence and program utilization. The findings suggest that individualized dose titration and frequent access to support may improve outcomes of patients initiated on weight reduction therapy with GLP-1 medications. These findings support the IVIM protocol as a safe, effective and individualized model for delivering obesity treatment through a curated, patient-centered, virtual approach.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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