Obesity Pillars最新文献

{"title":"Nutritional and lifestyle supportive care recommendations for management of obesity with GLP-1 - based therapies: An expert consensus statement using a modified Delphi approach","authors":"J.L. Sievenpiper ,&nbsp;J. Ard ,&nbsp;M. Blüher ,&nbsp;W. Chen ,&nbsp;J.B. Dixon ,&nbsp;A. Fitch ,&nbsp;L. Gigliotti ,&nbsp;K. Khunti ,&nbsp;A. Lecube ,&nbsp;M.E.J. Lean ,&nbsp;B. Mittendorfer ,&nbsp;A.F.H. Pfeiffer ,&nbsp;D.H. Ryan ,&nbsp;T. Vilsbøll ,&nbsp;L.F. Van Gaal","doi":"10.1016/j.obpill.2025.100228","DOIUrl":"10.1016/j.obpill.2025.100228","url":null,"abstract":"<div><h3>Background</h3><div>Liraglutide, semaglutide and tirzepatide have transformed the management of obesity. However, dose-related gastrointestinal effects, obesity-associated nutritional insufficiencies, and poor long-term adherence may limit their long-term health benefits. Despite a recent joint advisory summarizing nutritional and lifestyle supportive care priorities with these therapies, there is still a significant lack of direct evidence to guide clinical practice, making consensus-based recommendations necessary.</div></div><div><h3>Methods</h3><div>The consensus statement development was based on an initial scoping review that included searching PubMed, Embase, Web of Science, Cochrane, and Medline for relevant scientific publications from January 1, 2021 through June 30, 2025. An international multidisciplinary panel consisting of physicians, clinical researchers, and dietitians employed a modified Delphi process to develop clinical practice recommendations for nutritional and lifestyle strategies that may assist people on glucagon-like peptide 1 based therapies (GBT) in optimizing treatment experience and improving health outcomes.</div></div><div><h3>Results</h3><div>A total of 52 consensus statements were developed, outlining key considerations for the practical management of obesity and associated complications with GBTs, with a focus on nutritional factors in relation to obesity, body composition, physical activity, and the management of common gastrointestinal symptoms such as nausea, vomiting, diarrhoea, and constipation. The consensus statements include practical strategies supporting the weight loss journey, from before starting a GBT, during the weight loss and weight maintenance phases, and in case of GBT discontinuation. The statements were primarily derived from indirect evidence, including from existing evidence and established guidelines for nutrition therapy in bariatric medicine and relevant clinical experience.</div></div><div><h3>Conclusions</h3><div>These expert consensus recommendations offer healthcare professionals practical guidance on nutritional and lifestyle interventions for patients undergoing GBT-related weight management, complementing current recommendations. Further direct evidence is urgently required to inform and enhance optimal clinical care.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799725","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}

{"title":"Real-world effects of incretin-based Obesity medications on body composition","authors":"Rahila Bhatti ,&nbsp;Amena Sadiya ,&nbsp;Bashair M. Mussa ,&nbsp;Rawoof Khan ,&nbsp;Salah Abusnana","doi":"10.1016/j.obpill.2025.100229","DOIUrl":"10.1016/j.obpill.2025.100229","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the real-world impact of incretin-based obesity medications Semaglutide and Tirzepatide on body composition in people with obesity. The primary outcomes included changes in weight, waist circumference, skeletal muscle mass, fat mass, and visceral fat over 12 months.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted at Genesis Healthcare Centre, Dubai, UAE, from October 2022 to September 2024. A total of 269 adults (BMI ≥30 kg/m² or ≥27 kg/m² with obesity-related complications) who were prescribed Semaglutide or Tirzepatide as part of a comprehensive, multidisciplinary weight management program were included. Body composition was assessed using the InBody 370S analyzer. Data were extracted from the health information system. A repeated measures ANOVA was used to determine significance (p &lt; 0.05) in the statistical analyses, which were conducted using SPSS v29.</div></div><div><h3>Results</h3><div>Both medications significantly reduced weight, BMI, waist circumference, waist-to-height ratio, fat mass, and visceral fat (p &lt; 0.001). At 6 months, weight loss was similar (−9.09 % vs −10.7 %), but by 12 months, Tirzepatide achieved greater reduction (22.02 % vs 11.59 %). Both improved glycemic control and liver function. Females exhibited greater weight loss. Lifestyle interventions supported skeletal muscle mass preservation.</div></div><div><h3>Conclusion</h3><div>Semaglutide and Tirzepatide, significantly improved body composition, weight loss, and metabolic parameters in people with obesity. Tirzepatide demonstrated greater long-term efficacy.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145527906","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}

{"title":"Using the stages of change model to develop an understanding of caregiver intent for family behavior change following pediatric testing for genetic obesity: A qualitative analysis","authors":"Eileen Chaves ,&nbsp;Emily Kunkler","doi":"10.1016/j.obpill.2025.100227","DOIUrl":"10.1016/j.obpill.2025.100227","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity rates continue to rise in children and adolescents worldwide. The heritability of obesity is estimated to be 40–80 %. Genetic testing for monogenic causes of obesity in the clinical setting is increasing; however, how results of these tests affect family behaviors is unclear. The objective of this study was to understand caregiver intent to change family behaviors following genetic testing for obesity.</div></div><div><h3>Methods</h3><div>The sample from this qualitative analysis derives from a larger study identifying mutations on the melanocortin 4 receptor (MC4R) pathway. Inclusion criteria included participation in the main study, aged 2–17 years, and a history of severe obesity and hyperphagia. Caregiver-child dyads were recruited to ensure equal representation of genetic results across racial/ethnic subgroups (Non-Hispanic White, Black, Hispanic). A third of participants in the main study enrolled in the sub-study. Structured caregiver interviews were analyzed using grounded theory.</div></div><div><h3>Results</h3><div>Twenty caregivers were female, 55 % White, 45 % Black, and 5 % Hispanic. Mean caregiver age was 42.3 ± 6.5 years and BMI 40.5 ± 7.9 kg/m². Majority of children were male (55 %), mean age was 10.0 ± 4.7 years and BMI 40.8 ± 9.9 kg/m². Interview themes related to all stages except for maintenance stage in the Stages of Change Model (SoC). After receiving their child's genetic test results, regardless of outcome, the majority of caregivers in the study reported either remaining in the contemplation, preparation, or action stage or were motivated to move forward to a more action-oriented stage.</div></div><div><h3>Conclusions</h3><div>Genetic testing for pediatric obesity, regardless of test outcome, motivates caregivers to move forward within the SoC Model or to remain in their current stage. These findings suggest that engaging caregivers to have their child with obesity tested for a genetic cause of obesity does not cause families to stop engaging in behavior change, unless the family was not ready to engage in behavior change prior to genetic testing.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145527907","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}

{"title":"Resolution of chronic idiopathic urticaria with setmelanotide in a patient with Bardet-Biedl Syndrome: A case report","authors":"Kate Haggerty ,&nbsp;Jennifer Black ,&nbsp;Ruth Abeles","doi":"10.1016/j.obpill.2025.100221","DOIUrl":"10.1016/j.obpill.2025.100221","url":null,"abstract":"<div><h3>Introduction</h3><div>This case describes the resolution of refractory chronic idiopathic urticaria (CIU) with setmelanotide in a patient with Bardet-Biedl Syndrome (BBS). While setmelanotide is approved for syndromic obesity, this report highlights a novel anti-inflammatory effect potentially mediated by melanocortin-4 receptor (MC4R) agonism, expanding current understanding of its immunomodulatory role in mast cell–mediated disease.</div></div><div><h3>Main symptoms and clinical findings</h3><div>The patient presented with lifelong hyperphagia and class III obesity beginning in childhood, along with multiple features fulfilling BBS clinical criteria: visual impairment with night vision difficulties, renal abnormalities with proteinuria, irregular menses with polycystic ovaries, and neurodevelopmental delay. She also reported refractory CIU with pruritic hives occurring several times weekly despite dual antihistamine therapy. On examination, BMI was 40.5 kg/m², and dermatologic evaluation confirmed recurrent hives unresponsive to standard treatment.</div></div><div><h3>Diagnosis</h3><div>Genetic testing revealed a heterozygous pathogenic <em>BBS9</em> variant (c.1120C &gt; T; p. Arg374∗), supporting a BBS diagnosis. Secondary causes of urticaria were excluded. Setmelanotide was initiated at 2 mg daily and titrated to 3 mg, leading to complete urticaria resolution within three weeks and cessation of antihistamines. Symptoms recurred during a brief treatment pause and resolved upon reinitiation, demonstrating a temporal association. Hyperphagia scores improved from 20 to 0, with significant quality-of-life gains. Adjunct phentermine 18.75 mg daily was later added to optimize appetite control. After ten months, urticaria remained in sustained remission, with only one isolated cold-induced episode.</div></div><div><h3>Conclusion</h3><div>Setmelanotide produced durable remission of refractory CIU in a patient with BBS, suggesting MC4R agonism may exert immunomodulatory effects beyond weight regulation. This finding underscores the broader potential of precision therapies for rare obesity syndromes to reveal new mechanisms of inflammation control.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100221"},"PeriodicalIF":0.0,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145579027","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}

{"title":"Childhood obesity management in primary care: Bridging guidelines and practice","authors":"Venkata Sushma Chamarthi ,&nbsp;Jennifer Lynn McCauley ,&nbsp;Evan P. Nadler ,&nbsp;Sarah Ro","doi":"10.1016/j.obpill.2025.100225","DOIUrl":"10.1016/j.obpill.2025.100225","url":null,"abstract":"<div><h3>Introduction</h3><div>Childhood obesity continues to escalate in prevalence and severity, affecting nearly one in five U.S. children. Severe obesity is the fastest-growing subcategory, with disproportionately high rates among adolescents, non-Hispanic Black and Hispanic youth, and those from lower socioeconomic backgrounds. The resulting burden spans the life course, increasing risks for metabolic, cardiovascular, and psychosocial complications.</div></div><div><h3>Methods</h3><div>This is a narrative commentary based on a synthesis of current literature, clinical guidelines, and expert consensus regarding the integration of obesity management into pediatric primary care. The manuscript draws upon recent epidemiologic data, educational frameworks, and policy recommendations to highlight opportunities for workforce development and training reform.</div></div><div><h3>Results</h3><div>Key findings emphasize significant gaps between guideline recommendations and real-world practice. Despite strong evidence for early intervention, most pediatricians receive limited formal training in obesity medicine, leaving them unprepared to deliver pharmacotherapy, coordinate bariatric referrals, or manage comorbidities. The commentary identifies actionable strategies to address these deficits, including integration of obesity medicine into undergraduate and graduate medical education, expansion of continuing medical education and mentorship pathways, and the role of certification programs such as the American Board of Obesity Medicine (ABOM) in advancing competency across the pediatric workforce.</div></div><div><h3>Conclusion</h3><div>Bridging the gap between guidelines and practice requires a national commitment to equip primary care providers with the skills and confidence to treat obesity as a chronic disease. Embedding obesity medicine training into medical curricula, supporting practicing clinicians through structured continuing education, and advocating for system-level changes such as reimbursement reform and telehealth expansion are critical to reversing the pediatric obesity epidemic.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473666","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}

{"title":"An obesity care curriculum improves residents’ self-efficacy and clinical practice habits","authors":"Marci Laudenslager ,&nbsp;Kacey Chae ,&nbsp;Sean Tackett ,&nbsp;Amanda Bertram ,&nbsp;Kimberly A. Gudzune","doi":"10.1016/j.obpill.2025.100223","DOIUrl":"10.1016/j.obpill.2025.100223","url":null,"abstract":"<div><h3>Background</h3><div>Most residency programs lack formal curricula on obesity care leaving physicians unprepared to treat obesity. After conducting a targeted needs assessment, we refined a previously developed online obesity care curriculum and determined its effect on resident physicians’ outcomes.</div></div><div><h3>Methods</h3><div>This study employed a prospective, non-randomized, pre-post design to evaluate the impact of an online obesity care curriculum on resident physicians' obesity care self-efficacy and frequency of self-reported clinical practice habits. Participants included internal medicine, family medicine, preventive medicine, and internal medicine-pediatrics residents. The curriculum was offered as a standalone experience (‘curriculum only’) or part of a 10-day obesity medicine elective (‘curriculum + elective’). We recruited 45 residents – 33 selected the ‘curriculum only’ and 12 selected the ‘curriculum + elective’ option. We evaluated changes pre/post across 10 obesity care self-efficacy domains (1-not at all confident; 4-very confident) and self-reported frequency of 10 clinical practice habits (1-never; 5-always) among all residents. We used paired t-tests to calculate mean pre/post changes and compared outcomes between the ‘curriculum only’ and ‘curriculum + elective’ groups using unpaired t-tests. Given the multiple comparisons, we considered a statistically significant result if p-value &lt;0.005 (Bonferroni correction).</div></div><div><h3>Results</h3><div>Overall, residents completed a mean of 9.5 (SD 2.7) of 11 core e-modules. Residents significantly increased self-efficacy and frequency across obesity care domains (p &lt; 0.005); largest increases in frequency were in discussing metabolic-bariatric surgery (mean change 0.8, SD 1.0), behavioral counseling (0.8, SD 1.2), referring to weight management programs (0.7, SD 0.7), and discussing obesity medications (0.6, SD 0.9). No significant differences in pre/post changes were found comparing ‘curriculum only’ to ‘curriculum + elective.’</div></div><div><h3>Conclusion</h3><div>This curriculum's positive impact on clinical practice habits is an important precursor that may lead to changes in treatment outcomes for patients with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473667","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}

{"title":"Physical activity as a moderator of the association between central obesity and Type 2 diabetes in Asian American older adults","authors":"Kevin H. Kim ,&nbsp;Mojgan Sami ,&nbsp;Kathleen S. Wilson ,&nbsp;Koren L. Fisher","doi":"10.1016/j.obpill.2025.100224","DOIUrl":"10.1016/j.obpill.2025.100224","url":null,"abstract":"<div><h3>Background</h3><div>Asian American older adults (65+) face elevated risks for central obesity and Type 2 diabetes mellitus (T2DM). This study tested whether moderate to vigorous physical activity (MVPA) moderates the association between central obesity and T2DM, hypothesizing that the odds of T2DM linked to central obesity would be lower at higher levels of MVPA.</div></div><div><h3>Methods</h3><div>Generalized logistic regression models were used to test whether MVPA moderated the association between central obesity and T2DM, adjusting for demographic, cultural, and health-related covariates. Moderation was evaluated by comparing odds ratios from models using uncentered versus centered interaction terms.</div></div><div><h3>Results</h3><div>MVPA significantly moderated the association between central obesity and T2DM risk in older Asian Americans. Among individuals with central obesity, achieving the recommended threshold of 150 min of MVPA per week was associated with 43 % lower odds of T2DM (p &lt; 0.001), based on comparisons of regression models incorporating uncentered versus centered interaction terms.</div></div><div><h3>Conclusion</h3><div>Increasing time spent in MVPA was associated with a lower likelihood of T2DM among Asian American older adults with central obesity. Further research examining these associations within specific Asian American subgroups will be critical for the development of culturally relevant recommendations and tailored lifestyle interventions with the potential to address diabetes-related health disparities in this population.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100224"},"PeriodicalIF":0.0,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528506","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}

{"title":"Systematic review of parental influence on pediatric obesity: Exploring dietary habits, physical activity, and intervention strategies","authors":"Surendra Gupta ,&nbsp;Purushottam Lal ,&nbsp;Rakesh Sharma ,&nbsp;Abhishek Gupta ,&nbsp;Brajesh Raj Chaudhary","doi":"10.1016/j.obpill.2025.100218","DOIUrl":"10.1016/j.obpill.2025.100218","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this systematic review was to synthesize current evidence on the effectiveness of family-centered interventions that target parental behaviors such as dietary habits, physical activity, and sedentary patterns, in reducing childhood obesity risk. Rather than examining parental behaviors as independent predictors, this review focuses on interventions designed to modify them.</div></div><div><h3>Material and methods</h3><div>A comprehensive literature search was conducted using electronic databases including Medline/PubMed and EMBASE, supplemented by hand searching. Eligible studies included randomized controlled trials, quasi-experimental, observational, qualitative, and mixed-methods designs involving children aged 0–18 years. Interventions focused on parental behaviors related to diet, physical activity, and sedentary habits. Data extraction was performed independently by two reviewers, with risk of bias assessed using standard tools appropriate to study design. Narrative synthesis and meta-analyses, where appropriate, were conducted using random-effects models to account for study heterogeneity.</div></div><div><h3>Results</h3><div>Five randomized controlled trials met inclusion criteria, encompassing parent-only and family-based behavioral interventions across diverse populations. Parent-focused interventions with booster sessions consistently demonstrated significant reductions in children's body mass index z-scores compared to standard or no intervention. Secondary outcomes, including improvements in dietary habits and psychosocial factors, were reported but with less consistency. Risk of bias was low to moderate overall, though limitations included small sample sizes and variable follow-up durations.</div></div><div><h3>Conclusions</h3><div>Parental involvement is pivotal in pediatric obesity management. Family-centered behavioral interventions, particularly those incorporating booster supports, effectively reduce childhood obesity risk. Limitations of current evidence include methodological heterogeneity and limited long-term data. Future research should focus on paternal roles, diverse populations, and standardized outcome reporting. Systematic review registration: PROSPERO [CRD42025640314].</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473672","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}

{"title":"Perceived benefits of treatment for obesity with retatrutide: A qualitative study of patients in a phase 2 clinical trial","authors":"Iris A. Goetz ,&nbsp;Chisom Kanu ,&nbsp;Anastasia Hoover ,&nbsp;Cecilia Jimenez-Moreno ,&nbsp;Hayley Karn ,&nbsp;Miriam Kimel ,&nbsp;Lisa M. Neff ,&nbsp;Kristina S. Boye","doi":"10.1016/j.obpill.2025.100220","DOIUrl":"10.1016/j.obpill.2025.100220","url":null,"abstract":"<div><h3>Background</h3><div>Retatrutide, an agonist of glucose-dependent insulinotropic polypeptide, glucagon-like peptide-1, and glucagon receptors, is in development for the treatment of obesity. We interviewed participants exiting a phase 2 trial to understand the impact of retatrutide on eating behaviors, physical aspects, emotions, and lifestyle.</div></div><div><h3>Methods</h3><div>This was a qualitative exit interview study conducted in the US. Participants were adults with obesity or overweight and weight-related complications exiting the phase 2, double-blind, placebo-controlled trial of retatrutide (1, 4, 8, and 12 mg) (NCT04881760). Telephone interviews were conducted using a semi-structured interview guide. Interviews were recorded, transcribed, and analyzed using ATLAS.ti.</div></div><div><h3>Results</h3><div>Participants (N = 40; mean age 51 years; 52.5 % male) received retatrutide 4/8/12 mg (n = 23), retatrutide 1 mg (n = 13), or placebo (n = 4). Thirty-one of 36 retatrutide-treated participants reported changes in eating behaviors within the trial's first 8 weeks. Participants described eating less often or smaller portions, feeling hungry less often, feeling full after eating, having different food preferences, and feeling more in control of their eating. They also described feeling good about themselves or self-confident (n = 32) and feeling happy (n = 25). Participants reported improvements in mobility or ability to perform physical activities (n = 27), energy levels (n = 24), social activities involving food (n = 18), exercise (n = 19), and leisure activities (n = 17), as well as reduction in clothing size (n = 24). Some retatrutide-treated participants reported reduced participation in social activities due to adverse events (n = 2) or new eating habits (n = 2) and frustration due to disappointing weight loss (n = 3). Thirty of 36 retatrutide-treated participants had weight reduction as a goal, and 76.7 % reported achieving their goal.</div></div><div><h3>Conclusion</h3><div>In this exit interview analysis of adult study participants, those treated with retatrutide reported early changes in eating behavior, improved physical and emotional well-being, and weight reduction goal achievement. Some participants experienced social limitations or frustration due to adverse events or unmet expectations (NCT04881760).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100220"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424611","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}

{"title":"Optimizing GLP-1 therapies for obesity and diabetes management","authors":"Jarvis C. Noronha ,&nbsp;Luc F. Van Gaal ,&nbsp;Ian J. Neeland ,&nbsp;Angela Fitch ,&nbsp;Andreas FH. Pfeiffer ,&nbsp;Laura Chiavaroli ,&nbsp;Cyril WC. Kendall ,&nbsp;John L. Sievenpiper","doi":"10.1016/j.obpill.2025.100222","DOIUrl":"10.1016/j.obpill.2025.100222","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 (GLP-1) therapies are highly effective for weight loss and metabolic improvement in obesity and type 2 diabetes management. However, their use poses clinical challenges, including loss of lean muscle mass and gastrointestinal side effects, both of which may affect adherence and long-term outcomes.</div></div><div><h3>Methods</h3><div>This commentary synthesizes current evidence and expert perspectives, drawing on presentations from the 42nd International Symposium on Diabetes and Nutrition by the Diabetes and Nutrition Study Group, to develop practical recommendations for integrating nutrition and physical activity with GLP-1 therapies for obesity and diabetes management.</div></div><div><h3>Results</h3><div>We summarize consensus recommendations from a global working group, organized into seven thematic modules, to guide alignment of GLP-1 therapies with dietary and lifestyle interventions across the key stages of the weight management journey. Evidence from several clinical trials demonstrate that the combination of GLP-1 therapies with structured dietary and exercise interventions results in additive weight loss effects compared with either strategy alone. Strategies to preserve lean mass with GLP-1 therapies include achieving protein intakes &gt;1.2 g/kg/day, evenly distributed across meals, combined with aerobic activity and structured resistance training. Specific recommendations are provided to minimize nausea, vomiting, diarrhea, and constipation associated with GLP-1 therapies, as well as to prevent and manage complications such as, cholelithiasis and gastroesophageal reflux disease. Future research priorities include examining the impact of GLP-1 therapies on dietary habits and physical activity levels, improving muscle health assessment, and testing pharmacologic adjuncts to limit lean mass loss.</div></div><div><h3>Conclusion</h3><div>Maximizing the benefits of GLP-1 therapies require a multidisciplinary approach that integrates evidence-based nutrition, physical activity, and proactive management of gastrointestinal side effects. Such an approach can enhance adherence, preserve functional capacity, and sustain the long-term benefits of these therapies.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100222"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145528505","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}