Obesity Pillars最新文献

Taking back control: The experience of adults using semaglutide and tirzepatide for obesity treatment - A qualitative study 拿回控制权：成人使用西马鲁肽和替西帕肽治疗肥胖的经验-一项定性研究

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-11-25 DOI: 10.1016/j.obpill.2025.100237

Lauren Lynn Trocchio , Fredrick Peters

Background

Adequately treating obesity remains a fundamental goal for improving quality of life and long-term health outcomes. Semaglutide and tirzepatide have shown clinically meaningful weight loss in clinical trials, yet despite this weight loss efficacy, little is understood about how patients with obesity using semaglutide or tirzepatide experience making dietary behavior change. Furthermore, little is known about their perceptions of obesity treatment and healthcare provider interactions since taking the medications.

Methods

This was a basic qualitative study wherein adults with obesity taking semaglutide or tirzepatide participated in in-depth interviews and open-ended questionnaires. Participation criteria included a Body Mass Index (BMI) ≥ 30.0 kg/m², taking semaglutide (between 1.0 and 2.4 mg) or tirzepatide (between 5.0 and 15.0 mg) for 6–18 months, and a weight loss of 7 %–20 %. Individual demographic data were reported, and interview transcripts and questionnaires were thematically analyzed.

Results

The final sample included 8 participants (100 % female, mean age 42). Three themes addressed the experience of dietary behavior change: (a) feeling more capable, (b) more measured and deliberate with dietary choices, and (c) experiencing a reduced mental burden. Four themes addressed the experience of obesity treatment: (a) frustration with historical guidance and treatment, (b) hopeful about treatment for the first time, (c) compassion for self and others, and (d) unanticipated outcomes. Finally, two themes addressed the experience of healthcare provider interactions: (a) physicians as gatekeepers to the medications, and (b) physicians were not the initial introduction to the medications.

Conclusion

The findings suggest the medications provide a sense of hope for effective treatment, facilitate dietary behavior change, and evoke quality of life benefits beyond weight loss. The patient-provider relationship and obesity knowledge of the physician are integral in discussing and acquiring the medications, yet patients initially learn about the medications outside the healthcare system.

充分治疗肥胖仍然是改善生活质量和长期健康结果的基本目标。在临床试验中，塞马鲁肽和替西帕肽显示出具有临床意义的减肥效果，然而，尽管有这种减肥效果，但对于使用塞马鲁肽或替西帕肽的肥胖患者如何改变饮食行为知之甚少。此外，自服用药物以来，他们对肥胖治疗和医疗保健提供者互动的看法知之甚少。方法采用基础定性研究方法，对服用西马鲁肽或替西帕肽的成人肥胖患者进行深度访谈和开放式问卷调查。参与标准包括身体质量指数(BMI)≥30.0 kg/m2，服用西马鲁肽（1.0 - 2.4 mg）或替西帕肽（5.0 - 15.0 mg） 6-18个月，体重减轻7% - 20%。报告了个人人口统计数据，并对访谈记录和问卷进行了主题分析。结果最终样本包括8名参与者（100%为女性，平均年龄42岁）。三个主题涉及饮食行为改变的体验：(a)感觉更有能力，(b)在饮食选择上更有节制和深思熟虑，(c)精神负担减轻。四个主题讨论了肥胖治疗的经验：(a)对历史指导和治疗的沮丧，(b)对第一次治疗的希望，(c)对自己和他人的同情，以及(d)意想不到的结果。最后，两个主题涉及医疗保健提供者互动的经验：(a)医生作为药物的看门人，以及(b)医生不是药物的最初介绍。结论该研究结果表明，药物治疗提供了有效治疗的希望，促进了饮食行为的改变，并唤起了减肥以外的生活质量益处。在讨论和获得药物时，医患关系和医生的肥胖知识是不可或缺的，然而患者最初是在医疗保健系统之外了解药物的。

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引用次数: 0

Applicability of the New Zealand-eating behavior questionnaire to predict weight loss responses to naltrexone/bupropion: a proof-of-concept trial 新西兰饮食行为问卷预测纳曲酮/安非他酮减肥反应的适用性：一项概念验证试验

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-12-05 DOI: 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）。

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引用次数: 0

Outcomes of obesity medications in those with low response to a low-energy diet meal replacement programme: An observational study 对低能量饮食替代方案反应低的肥胖药物治疗结果：一项观察性研究

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2026-01-03 DOI: 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.

背景：目前尚不清楚在结构化膳食替代低能量饮食（MR-LED）方案低反应后个体对利拉鲁肽或纳曲酮/安非他酮的反应。方法：本研究是一项回顾性观察性研究，在一家专业体重管理服务机构进行，采用磁共振成像（mri）和强化行为治疗（IBT）。如果成年人在强化MR阶段的前4周体重没有减轻至少5%，在12周MR阶段后体重没有减轻10%，或者在分步食物重新引入或体重维持阶段体重没有恢复4公斤，则可以考虑服用肥胖药物。符合条件的患者给予利拉鲁肽3.0 mg （LIRA）或纳曲酮/安非他酮（NB32）治疗13周（包括剂量滴定）。主要终点是治疗13周后体重减轻≥5%的个体比例。完成者被定义为那些在10到16周之间测量体重并且在此之前没有停药的人。结果在114名接受减肥药治疗的患者中，85人接受治疗（67 LIRA, 18 NB32）。46人完成了13周的治疗，11人（24%）体重减轻≥5%。在完成者（54%）中，平均体重变化为- 4.4 kg(- 2.4%)，在使用缺失数据结转的最后体重的总治疗队列中，平均体重变化为- 2.7 kg（- 1.5%）。体重减轻≥5%的患者更有可能是男性，并且在基线时糖尿病、暴饮暴食、焦虑或抑郁症状的患病率较低。结论：MR-LED合并IBT治疗无效的患者在随后的第一代肥胖药物治疗中体重减轻率低于预期。

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引用次数: 0

Testosterone therapy effects adipose distribution in older females post hip-fracture: The STEP-HI study 睾酮治疗对老年女性髋部骨折后脂肪分布的影响：STEP-HI研究

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2026-01-12 DOI: 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":"2026-03-01","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}

引用次数: 0

Laparoscopic sleeve gastrectomy in a patient with type 1 diabetes and kidney transplant: A case report 1型糖尿病并发肾移植的腹腔镜袖胃切除术1例报告

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-12-16 DOI: 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.

1型糖尿病（T1DM）和肾脏疾病患者的肥胖带来了独特的挑战，特别是在移植后，体重增加会损害移植物功能和代谢控制。减肥手术已成为肥胖移植受者的一种治疗选择，尽管其在T1DM中的作用尚未得到充分探讨。我们报告了一例45岁的长期T1DM合并高血压、糖尿病视网膜病变和终末期肾脏疾病的男性患者，他在40岁时接受了已故供者肾移植。移植后，患者出现III型肥胖（BMI 44.5 kg/m2），血糖控制不佳（HbA1c 9.8%），尽管进行了强化治疗，但仍出现严重的肝脂肪变性。干预方法：腹腔镜袖胃切除术无术中并发症（手术时间70分钟，标本重量100 g，出血量最小）。术后只有短暂性肠梗阻需要住院两天。在随访中，患者表现出明显的体重减轻，蛋白尿缓解，血糖稳定性改善，胰岛素需求显著降低，肝脂肪变性改善。重要的是，免疫抑制药物水平在随访期间始终保持在治疗范围内。结论：该病例强调了袖胃切除术治疗长期T1DM肾移植患者的安全性和有效性，在不影响移植物功能或免疫抑制治疗的情况下，显著改善了代谢、肾脏和肝脏。据我们所知，这是首例报道的T1DM患者肾移植后进行袖式胃切除术的病例，强调了其可行性和在这一复杂人群中进一步研究的必要性。

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引用次数: 0

Obesity Medicine Association (OMA) Position Statement on Medicare and Medicaid coverage and expanded access to obesity medications: Preliminary perspective 2025 肥胖医学协会（OMA）关于医疗保险和医疗补助覆盖范围和扩大获得肥胖药物的立场声明：初步展望2025

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-12-09 DOI: 10.1016/j.obpill.2025.100242

Marisa Censani , Angela Fitch , Carolynn Starr Francavilla Brown , Harold Edward Bays

引用次数: 0

Obesity pillars roundtable: Better together - combined obesity medicine and metabolic surgery care for the treatment of obesity 肥胖支柱圆桌会议：更好地结合-肥胖药物和代谢手术护理治疗肥胖

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-11-21 DOI: 10.1016/j.obpill.2025.100232

Kirsten Frederiksen , Reed A. Berger-Fleishman , Ahmed Jad , Samer G. Mattar , Bharti Shetye

Background

Obesity is a chronic, multifactorial, complex, and relapsing disease typically requiring treatment from various medical providers throughout the continuum of care. A natural overlap in medical and procedural obesity treatment therefore often exists during the course of treatment. Given this, the optimal treatment of the medically complex patient population may best be delivered either within multi-disciplinary teams, or through more effective collaboration with diverse specialists sharing the common interest of managing patients with obesity. The aim of this roundtable is to more deeply engage on issues surrounding the multi-disciplinary approach for the treatment of obesity, along with highlighting areas of opportunity for improving collaborative care.

Methods

This roundtable review includes perspectives from two obesity medicine specialists and two metabolic bariatric surgeons, all with extensive experience in combining medical and surgical care.

Results

While the panelists generally agreed upon core principles of combined obesity medicine and metabolic surgical care for the treatment of obesity, each had their own priorities and approach regarding the best ways to overlap care. Variances in perceptions included importance of procedural care versus use of pharmacotherapy. However, the panelists endorsed more collaborative work as vital for improving outcomes. Further identification of existing barriers and the creation of pathways for action will bring this work forward.

Conclusions

Providing guidance on one universal approach to the care of patients with obesity is challenging due to the heterogeneity of patient populations and variance in practice patterns across the spectrum of care. The panel suggested adopting a continuum-of-care mindset, meaning that all available options should be considered for patients, either in sequence, or as adjuvant therapies, or as rescue options for patients who gain tolerance to a particular therapeutic modality. This approach is in keeping with the reality that obesity is a chronic, relapsing multifactorial disease.

背景：肥胖是一种慢性的、多因素的、复杂的、反复发作的疾病，通常需要不同的医疗提供者在连续的护理过程中进行治疗。因此，在治疗过程中，医学和程序性肥胖治疗经常存在自然重叠。鉴于此，对医学上复杂的患者群体的最佳治疗可能最好是在多学科团队中进行，或者通过与不同专家更有效的合作，分享管理肥胖患者的共同兴趣。本次圆桌会议的目的是更深入地探讨围绕多学科方法治疗肥胖的问题，同时强调改善协作护理的机会领域。方法本次圆桌会议综述包括两位肥胖医学专家和两位代谢减肥外科医生的观点，他们都具有丰富的内外科结合护理经验。结果虽然小组成员普遍同意联合肥胖药物和代谢手术治疗肥胖的核心原则，但对于重叠治疗的最佳方式，每个人都有自己的优先事项和方法。认知上的差异包括程序性护理与药物治疗的重要性。然而，小组成员赞同更多的协作工作对于改善结果至关重要。进一步查明现有障碍和创造行动途径将推动这项工作向前发展。结论：由于患者群体的异质性和护理范围内实践模式的差异，为肥胖患者提供一种通用方法的指导是具有挑战性的。专家组建议采用连续治疗的思维方式，这意味着所有可用的选择都应该考虑到患者，无论是按顺序，还是作为辅助治疗，或者作为对特定治疗方式产生耐受性的患者的拯救选择。这种方法符合肥胖是一种慢性、反复发作的多因素疾病的现实。

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引用次数: 0

Microdosing of obesity medications: A Perspective Statement from the Access and Policy Working Group 微剂量的肥胖药物：从获取和政策工作组的观点声明

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-11-21 DOI: 10.1016/j.obpill.2025.100234

Christopher Weber , Bharti Shetye , Courtney Younglove , Catherine Varney , Leslie Golden , Harold Edward Bays

引用次数: 0

Adolescent obesity: Biochemical and dietary disparities in U.S. youth 青少年肥胖：美国青少年的生化和饮食差异

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2025-12-03 DOI: 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.

背景：青春期是成长的关键时期，营养需求增加，但许多美国青少年未能达到推荐的膳食摄入量。本研究分析了三个NHANES周期（2013-2018）的数据，以评估12-18岁青少年的肥胖趋势，通过BMI比较饮食摄入量，并评估营养生物标志物。方法：本回顾性观察性研究分析了三个NHANES周期的数据，以估计美国12-18岁青少年的肥胖患病率。比较了肥胖和非肥胖青少年的饮食摄入和血液中微量和大量营养素的浓度。根据CDC生长图表，BMI≥95百分位定义为肥胖。根据估计平均需要量（EAR）和充足摄入量（AI）基准评估营养摄入量，并使用既定的临床阈值评估生物标志物水平。所有统计分析均采用SAS版本9.4和SAS Enterprise Guide版本8.3进行。结果各周期肥胖患病率从20.3%小幅上升至21.3%。在分析的所有饮食摄入变量中，只有一个变量在肥胖人群和非肥胖人群之间显示出统计学上的显著差异。肥胖青少年的蛋白质摄入量明显低于EAR（50.3%比22.9%,P < 0.001）。超过一半的青少年没有达到几种营养素的推荐摄入量，无论他们的BMI类别如何。血液生物标志物分析显示，肥胖患者的维生素D、维生素C、血清铁、白蛋白和MCV水平明显较低，而总蛋白、球蛋白和hs-CRP水平较高（P≤0.05）。低维生素D、低血红蛋白、低MCV和缺铁性贫血的患病率在肥胖组也明显更高。该研究表明，尽管热量摄入相似，肥胖青少年表现出更高的营养缺乏率和炎症标志物。这项工作强调了认识到青少年护理中的营养差距的重要性。

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引用次数: 0

Editorial for Obesity Pillars: Special Issue “Obesity in Children and Adolescents and Therapy” 社论肥胖支柱：特刊“肥胖的儿童和青少年和治疗”。

Obesity Pillars

Pub Date : 2026-03-01 Epub Date: 2026-02-06 DOI: 10.1016/j.obpill.2026.100250

Suzanne E. Cuda MD, FAAP, MFOMA, DABOM (Executive Editor Obesity Pillars)

引用次数: 0