Pub Date : 2025-10-20DOI: 10.1016/j.obpill.2025.100216
Moshe Kamar , Donna H. Ryan , Sharon Leonard , Holly R. Wyatt , Yael Kenan , Liora Cohen Asaraf , Eti Ganon-Elazar , Jamy D. Ard
Background
Long-term weight-loss maintenance remains challenging despite of the numerous available treatments. The previously published pivotal randomized RESET study demonstrated a mean weight reduction from baseline of 6.6 % with Epitomee and a mean weight reduction of 4.6 % with placebo (p < 0.001). In this study we investigated the efficacy and safety of the extended use of Epitomee, an FDA cleared, non-pharmacological treatment for weight management.
Methods
In this open label extension study, a subset of participants in the RESET study who lost ≥3 % of initial body weight during a 24-week treatment with Epitomee capsule or placebo, as an adjunct to lifestyle counseling, were eligible for a 24-week open-label extension study (ELECT).
Results
Continuous treatment with Epitomee and lifestyle counseling for 48 weeks was associated with sustained reduction in body weight of 11.2 ± 8.4 % (p < 0.001) and sustained prior improvements in cardiometabolic risk factors and quality of life (QOL). Taking the Epitomee capsule for 24 weeks, after previous weight loss with the placebo treatment, was associated with an additional 1.5 ± 4.2 % weight loss, yielding a total 7.5 ± 5.5 % reduction at 48 weeks and additional improvements in QOL. Capsule adherence exceeded 94 %. Extended use of Epitomee had a favorable safety profile, with no serious adverse device-related events and no discontinuation due to adverse events.
Conclusions
In this open-label study, extended use of Epitomee, combined with lifestyle counseling, was associated with maintenance of prior weight loss and favorable safety profile (NCT04994769).
{"title":"The safety and efficacy of extended use of an oral shape-shifting superabsorbent hydrogel capsule for weight loss: The ELECT extension study","authors":"Moshe Kamar , Donna H. Ryan , Sharon Leonard , Holly R. Wyatt , Yael Kenan , Liora Cohen Asaraf , Eti Ganon-Elazar , Jamy D. Ard","doi":"10.1016/j.obpill.2025.100216","DOIUrl":"10.1016/j.obpill.2025.100216","url":null,"abstract":"<div><h3>Background</h3><div>Long-term weight-loss maintenance remains challenging despite of the numerous available treatments. The previously published pivotal randomized RESET study demonstrated a mean weight reduction from baseline of 6.6 % with Epitomee and a mean weight reduction of 4.6 % with placebo (p < 0.001). In this study we investigated the efficacy and safety of the extended use of Epitomee, an FDA cleared, non-pharmacological treatment for weight management.</div></div><div><h3>Methods</h3><div>In this open label extension study, a subset of participants in the RESET study who lost ≥3 % of initial body weight during a 24-week treatment with Epitomee capsule or placebo, as an adjunct to lifestyle counseling, were eligible for a 24-week open-label extension study (ELECT).</div></div><div><h3>Results</h3><div>Continuous treatment with Epitomee and lifestyle counseling for 48 weeks was associated with sustained reduction in body weight of 11.2 ± 8.4 % (p < 0.001) and sustained prior improvements in cardiometabolic risk factors and quality of life (QOL). Taking the Epitomee capsule for 24 weeks, after previous weight loss with the placebo treatment, was associated with an additional 1.5 ± 4.2 % weight loss, yielding a total 7.5 ± 5.5 % reduction at 48 weeks and additional improvements in QOL. Capsule adherence exceeded 94 %. Extended use of Epitomee had a favorable safety profile, with no serious adverse device-related events and no discontinuation due to adverse events.</div></div><div><h3>Conclusions</h3><div>In this open-label study, extended use of Epitomee, combined with lifestyle counseling, was associated with maintenance of prior weight loss and favorable safety profile (NCT04994769).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100216"},"PeriodicalIF":0.0,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424615","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 : 2025-10-08DOI: 10.1016/j.obpill.2025.100215
{"title":"Response to Letter to the Editor","authors":"","doi":"10.1016/j.obpill.2025.100215","DOIUrl":"10.1016/j.obpill.2025.100215","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265494","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 : 2025-10-01DOI: 10.1016/j.obpill.2025.100214
Jeremiah J. Trudeau , Brian Winger , Theresa Hunter Gibble , Lisa M. Neff , Chris Marshall , Chloe Carmichael , Daniel M. Ford , Elizabeth Collins
Background
Digital health technologies (DHTs) offer passive, objective, and continuous monitoring of difficult-to-report mobility-related behaviors like physical activity (PA) and functional mobility (FM), which are important concepts of interest in obesity-related clinical studies. This study was conducted to identify which aspects of FM/PA are meaningful to people living with obesity or overweight and establish how those concepts can be measured by passive monitoring using DHTs.
Methods
Qualitative concept elicitation interviews were conducted among 4 groups of adults (≥18 years) with obesity (body mass index [BMI] ≥30 kg/m2) and no obesity-related complications, overweight (BMI ≥27 kg/m2) with type 2 diabetes, overweight with obstructive sleep apnea, and overweight with lower-limb osteoarthritis. Two rounds of interviews were conducted to first identify the most important concepts of interest relating to FM/PA and then determine what level of change in FM and PA would be considered meaningful and important in the context of obesity treatment.
Results
A total of 48 participants were recruited for Round 1 (n = 24) and Round 2 (n = 24). The most frequently reported concepts of interest identified for FM and PA were walking on a flat surface, moderate-to-vigorous physical activity (MVPA), climbing stairs, walking uphill, and standing. All four most frequently reported concepts of FM/PA in Round 1 (MVPA, going up stairs, walking, and standing) were also considered relevant and bothersome in Round 2. The majority of the participants confirmed that measuring step count and changes in minutes of MVPA would be meaningful for them with respect to treatment for obesity.
Conclusion
People with obesity or overweight reported the ability to perform MVPA, going up stairs, walking, and standing as meaningful FM/PA outcomes. DHTs have the potential to provide relevant information about the functional status of people with obesity and could be more frequently implemented in obesity treatment studies and clinical practice.
{"title":"Exploring the role of digital health technologies in assessing functional mobility and physical activity: Insights from qualitative interviews in adults with obesity or overweight","authors":"Jeremiah J. Trudeau , Brian Winger , Theresa Hunter Gibble , Lisa M. Neff , Chris Marshall , Chloe Carmichael , Daniel M. Ford , Elizabeth Collins","doi":"10.1016/j.obpill.2025.100214","DOIUrl":"10.1016/j.obpill.2025.100214","url":null,"abstract":"<div><h3>Background</h3><div>Digital health technologies (DHTs) offer passive, objective, and continuous monitoring of difficult-to-report mobility-related behaviors like physical activity (PA) and functional mobility (FM), which are important concepts of interest in obesity-related clinical studies. This study was conducted to identify which aspects of FM/PA are meaningful to people living with obesity or overweight and establish how those concepts can be measured by passive monitoring using DHTs.</div></div><div><h3>Methods</h3><div>Qualitative concept elicitation interviews were conducted among 4 groups of adults (≥18 years) with obesity (body mass index [BMI] ≥30 kg/m<sup>2</sup>) and no obesity-related complications, overweight (BMI ≥27 kg/m<sup>2</sup>) with type 2 diabetes, overweight with obstructive sleep apnea, and overweight with lower-limb osteoarthritis. Two rounds of interviews were conducted to first identify the most important concepts of interest relating to FM/PA and then determine what level of change in FM and PA would be considered meaningful and important in the context of obesity treatment.</div></div><div><h3>Results</h3><div>A total of 48 participants were recruited for Round 1 (n = 24) and Round 2 (n = 24). The most frequently reported concepts of interest identified for FM and PA were walking on a flat surface, moderate-to-vigorous physical activity (MVPA), climbing stairs, walking uphill, and standing. All four most frequently reported concepts of FM/PA in Round 1 (MVPA, going up stairs, walking, and standing) were also considered relevant and bothersome in Round 2. The majority of the participants confirmed that measuring step count and changes in minutes of MVPA would be meaningful for them with respect to treatment for obesity.</div></div><div><h3>Conclusion</h3><div>People with obesity or overweight reported the ability to perform MVPA, going up stairs, walking, and standing as meaningful FM/PA outcomes. DHTs have the potential to provide relevant information about the functional status of people with obesity and could be more frequently implemented in obesity treatment studies and clinical practice.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100214"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265392","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}
Nuts generally blunt the postprandial increases in glucose levels and increase satiety, while yogurt studies yield inconclusive results regarding post-meal hunger. This study investigated the effects of high-protein, and high-fat snacks, specifically Greek yogurt, and peanuts, on satiety, gut hormones, and insulin secretion in women with overweight and obesity. The hypothesis posited that peanuts would exhibit a more beneficial impact on satiety, gut hormones, and insulin levels compared to Greek yogurt.
Methods
The two-arm parallel randomized trial involved fifty participants aged 30–40 years with a BMI between 25 and 35 kg/m2, randomly divided into peanut (n = 25) and Greek yogurt (n = 25) groups. After three days of adhering to 1200 Kcal diet, appetite sensations were gauged using a visual analog scale (VAS) upon arrival, and at 30- and 60-min post-snack. Pre- and post-snacking, plasma levels of cholecystokinin (CCK), Peptide Tyrosine-Tyrosine (PYY), Glucagon Like Peptide-1 (GLP-1), Ghrelin (GHRL), and insulin were analyzed.
Results
Revealed that Greek yogurt induced a statistically significant increase in satiety 30 min after consumption and markedly elevated postprandial insulin levels compared to peanuts. Moreover, notable intergroup differences in postprandial insulin concentrations were observed in the Greek yogurt group. The peanut group had no significant alterations in PYY, GLP-1, CCK or GHRL levels. Pre-snacking, GHRL levels exhibited a positive association with abdominal circumference, weight, and fat mass, while CCK levels displayed a negative association with abdominal circumference, weight, and fat mass.
Conclusion
Greek yogurt may enhance satiety and thus has the potential to positively influence body weight in individuals with overweight and/or obesity. Further research is required to elucidate appetite control mechanisms.
Trial registration
The study was registered on ClinicalTrials.gov (No. NCT 04518930).
{"title":"Exploring the effects of high protein versus high fat snacks on satiety, gut hormones and insulin secretion in women with overweight and obesity: A randomized clinical trial","authors":"Nahla Al-Bayyari , Maysoon Alhameedy , Razan Omoush , Hadeel Ghazzawi","doi":"10.1016/j.obpill.2025.100212","DOIUrl":"10.1016/j.obpill.2025.100212","url":null,"abstract":"<div><h3>Background</h3><div>Nuts generally blunt the postprandial increases in glucose levels and increase satiety, while yogurt studies yield inconclusive results regarding post-meal hunger. This study investigated the effects of high-protein, and high-fat snacks, specifically Greek yogurt, and peanuts, on satiety, gut hormones, and insulin secretion in women with overweight and obesity. The hypothesis posited that peanuts would exhibit a more beneficial impact on satiety, gut hormones, and insulin levels compared to Greek yogurt.</div></div><div><h3>Methods</h3><div>The two-arm parallel randomized trial involved fifty participants aged 30–40 years with a BMI between 25 and 35 kg/m<sup>2</sup>, randomly divided into peanut (n = 25) and Greek yogurt (n = 25) groups. After three days of adhering to 1200 Kcal diet, appetite sensations were gauged using a visual analog scale (VAS) upon arrival, and at 30- and 60-min post-snack. Pre- and post-snacking, plasma levels of cholecystokinin (CCK), Peptide Tyrosine-Tyrosine (PYY), Glucagon Like Peptide-1 (GLP-1), Ghrelin (GHRL), and insulin were analyzed.</div></div><div><h3>Results</h3><div>Revealed that Greek yogurt induced a statistically significant increase in satiety 30 min after consumption and markedly elevated postprandial insulin levels compared to peanuts. Moreover, notable intergroup differences in postprandial insulin concentrations were observed in the Greek yogurt group. The peanut group had no significant alterations in PYY, GLP-1, CCK or GHRL levels. Pre-snacking, GHRL levels exhibited a positive association with abdominal circumference, weight, and fat mass, while CCK levels displayed a negative association with abdominal circumference, weight, and fat mass.</div></div><div><h3>Conclusion</h3><div>Greek yogurt may enhance satiety and thus has the potential to positively influence body weight in individuals with overweight and/or obesity. Further research is required to elucidate appetite control mechanisms.</div></div><div><h3>Trial registration</h3><div>The study was registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (No. NCT 04518930).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227026","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 : 2025-09-25DOI: 10.1016/j.obpill.2025.100211
Adham Khalil , Alan J. Kim , Lawrence J. Cheskin , Selvi Rajagopal , Bill Morefield , Zoobia Chaudhry , Kimberly A. Gudzune , Clifford R. Weiss
Background
Bariatric arterial embolization (BAE) is an emerging, minimally invasive, image-guided procedure for treating obesity in patients for whom nonoperative treatments have failed and metabolic-bariatric surgery is not an option. BAE has shown success in clinical studies, but guidance on integrating BAE into weight management programs (WMPs) is lacking. We describe our experience with building a multidisciplinary clinical program that integrates BAE into routine care for obesity.
Methods
We conducted a retrospective, single-center observational case series of patients treated with BAE through our WMP between November 2021 and September 2023. Patient chart review was performed for the following criteria for consideration of BAE: had a body mass index ≥30 kg/m2, was unable to achieve weight and health goals through nonoperative management, and was ineligible or unwilling to undergo metabolic-bariatric surgery. Through multidisciplinary discussion, BAE was deemed suitable based on various patient-specific medical and technical reasons.
Results
Thirty-one patients were considered for BAE through the program. Of those, 9 patients were cleared for BAE and 5 patients (4 women and 1 man) eventually underwent BAE. The mean age of the embolized patients was 42 years (range: 28–56). The mean pre-procedure weight was 116 kg (range: 100–134). Patients achieved a mean total body weight loss of 7.0% at 4–5 months’ follow-up and 4.2% at 12 months. BAE was performed successfully with only transient nausea and vomiting postoperatively. The mean cost for BAE was $14,329 US dollars.
Conclusions
BAE offers an obesity treatment option with low complication risk and potential benefit when used as part of a comprehensive WMP. Close collaboration between interventional radiologists and obesity medicine physicians is key for success. BAE should be offered as a component within a comprehensive WMP rather than as a stand-alone procedure.
{"title":"Establishing a multidisciplinary bariatric arterial embolization program: A two-year clinical experience","authors":"Adham Khalil , Alan J. Kim , Lawrence J. Cheskin , Selvi Rajagopal , Bill Morefield , Zoobia Chaudhry , Kimberly A. Gudzune , Clifford R. Weiss","doi":"10.1016/j.obpill.2025.100211","DOIUrl":"10.1016/j.obpill.2025.100211","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric arterial embolization (BAE) is an emerging, minimally invasive, image-guided procedure for treating obesity in patients for whom nonoperative treatments have failed and metabolic-bariatric surgery is not an option. BAE has shown success in clinical studies, but guidance on integrating BAE into weight management programs (WMPs) is lacking. We describe our experience with building a multidisciplinary clinical program that integrates BAE into routine care for obesity.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-center observational case series of patients treated with BAE through our WMP between November 2021 and September 2023. Patient chart review was performed for the following criteria for consideration of BAE: had a body mass index ≥30 kg/m<sup>2</sup>, was unable to achieve weight and health goals through nonoperative management, and was ineligible or unwilling to undergo metabolic-bariatric surgery. Through multidisciplinary discussion, BAE was deemed suitable based on various patient-specific medical and technical reasons.</div></div><div><h3>Results</h3><div>Thirty-one patients were considered for BAE through the program. Of those, 9 patients were cleared for BAE and 5 patients (4 women and 1 man) eventually underwent BAE. The mean age of the embolized patients was 42 years (range: 28–56). The mean pre-procedure weight was 116 kg (range: 100–134). Patients achieved a mean total body weight loss of 7.0% at 4–5 months’ follow-up and 4.2% at 12 months. BAE was performed successfully with only transient nausea and vomiting postoperatively. The mean cost for BAE was $14,329 US dollars.</div></div><div><h3>Conclusions</h3><div>BAE offers an obesity treatment option with low complication risk and potential benefit when used as part of a comprehensive WMP. Close collaboration between interventional radiologists and obesity medicine physicians is key for success. BAE should be offered as a component within a comprehensive WMP rather than as a stand-alone procedure.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100211"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265495","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 : 2025-09-16DOI: 10.1016/j.obpill.2025.100210
{"title":"Letters to the editor regarding the “Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society”","authors":"","doi":"10.1016/j.obpill.2025.100210","DOIUrl":"10.1016/j.obpill.2025.100210","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105017","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}
Ultra-processed foods (UPFs) have become increasingly incorporated into pediatric diets, accounting for approximately 67 % of the total energy consumption in United States (US) children. Manufactured through industrial processing and enriched with excess sugars, unhealthy fats, and sodium, while lacking essential nutrients, UPFs present a substantial public health concern. We aimed to conduct a comprehensive review of the impact of UPFs on pediatric health.
Methods
We reviewed the effects of UPF on pediatric health using data from observational studies, systematic reviews, and policy reports. Our review explored the social, environmental, and economic drivers of UPF consumption, associated health consequences, and proposed mitigation strategies. We also examined National Health and Nutrition Examination Survey (NHANES) data, the 2025 US Dietary Guidelines Advisory Committee’s (USDA) report, and the Make America Healthy Again (MAHA) commission findings.
Results
UPF intake has dramatically increased during early childhood, with toddlers and school-aged children obtaining 47 % and 59.4 % of their daily calories, respectively, from UPFs. Higher consumption is linked to pediatric obesity, cardiometabolic risks such as insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), mental health concerns, and gut microbiome disruption. Early-life exposure to UPFs can establish unhealthy dietary patterns that persist into adulthood, raising the risk of chronic disease. Greater UPF consumption is often observed among lower-income families, highlighting a key health disparity.
Conclusion
UPF consumption is a modifiable risk factor for non-communicable diseases in children. Addressing it requires urgent, coordinated action at multiple levels. Strategies include UPF and sugar-sweetened beverage screening during well-child visits, policy restrictions on food marketing, clearer nutrition labeling, healthier school meals, and personalized family-centered dietary counseling. Clinicians need standardized tools and training to counsel families effectively. Policy initiatives should prioritize prevention-focused measures to protect children's health.
{"title":"The impact of ultra-processed foods on pediatric health","authors":"Venkata Sushma Chamarthi , Pallavi Shirsat , Kunal Sonavane , Saketh Parsi , Usha Ravi , Harikrishna Choudary Ponnam , Shagun Bindlish , Evan P. Nadler , Rahul Kashyap , Sarah Ro","doi":"10.1016/j.obpill.2025.100203","DOIUrl":"10.1016/j.obpill.2025.100203","url":null,"abstract":"<div><h3>Introduction</h3><div>Ultra-processed foods (UPFs) have become increasingly incorporated into pediatric diets, accounting for approximately 67 % of the total energy consumption in United States (US) children. Manufactured through industrial processing and enriched with excess sugars, unhealthy fats, and sodium, while lacking essential nutrients, UPFs present a substantial public health concern. We aimed to conduct a comprehensive review of the impact of UPFs on pediatric health.</div></div><div><h3>Methods</h3><div>We reviewed the effects of UPF on pediatric health using data from observational studies, systematic reviews, and policy reports. Our review explored the social, environmental, and economic drivers of UPF consumption, associated health consequences, and proposed mitigation strategies. We also examined National Health and Nutrition Examination Survey (NHANES) data, the 2025 US Dietary Guidelines Advisory Committee’s (USDA) report, and the Make America Healthy Again (MAHA) commission findings.</div></div><div><h3>Results</h3><div>UPF intake has dramatically increased during early childhood, with toddlers and school-aged children obtaining 47 % and 59.4 % of their daily calories, respectively, from UPFs. Higher consumption is linked to pediatric obesity, cardiometabolic risks such as insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), mental health concerns, and gut microbiome disruption. Early-life exposure to UPFs can establish unhealthy dietary patterns that persist into adulthood, raising the risk of chronic disease. Greater UPF consumption is often observed among lower-income families, highlighting a key health disparity.</div></div><div><h3>Conclusion</h3><div>UPF consumption is a modifiable risk factor for non-communicable diseases in children. Addressing it requires urgent, coordinated action at multiple levels. Strategies include UPF and sugar-sweetened beverage screening during well-child visits, policy restrictions on food marketing, clearer nutrition labeling, healthier school meals, and personalized family-centered dietary counseling. Clinicians need standardized tools and training to counsel families effectively. Policy initiatives should prioritize prevention-focused measures to protect children's health.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048595","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 : 2025-09-09DOI: 10.1016/j.obpill.2025.100207
Mohey Elbanna , Amany Falah , Ahmed Magdy Hafez
Background
Bariatric surgery is the most effective treatment for obesity in Adolescents. However, disordered eating is frequent in this population. Several studies found that disordered eating affects weight loss after bariatric surgery. The aim of this study was to find out the impact of disordered eating on weight loss in Egyptian adolescents two years after sleeve gastrectomy.
Methods
This is a retrospective cohort study conducted at Ain Shams University Hospitals from March 2020 to March 2024. It included 47 adolescents with obesity who underwent laparoscopic sleeve gastrectomy (LSG) two years before. Their age was 16.2 ± 0.67 years (range 14.5 – 17.8 years old). Their body mass indices were above 99th percentile for age and sex with or without comorbidities. They had a mean BMI of 39.9 kg/m² (range: 36.9 – 54.3 kg/m²). Patients with psychiatric illnesses and eating disorders were excluded. Patients were recruited after completion of two years of follow up for weight loss. Weight loss was evaluated by total weight loss % (TWL%). Disordered eating was detected by the Arabic version of EDE-Q v.6.0, and a global score of > 2.5 was considered positive. TWL% was correlated with EDE-Q score.
Results
After two years, the mean TWL% was 27.5% ± 7.7%. Nineteen patients (40.4%) had EDE-Q score more than 2.5. The EDE-Q positive patients had a mean %TWL of 25.7% ± 4.8%, while EDE-Q negative patients had a mean %TWL of 30.5% ± 6.2%. The difference is statistically significant.
Conclusion
We conclude that the outcome of sleeve gastrectomy in adolescents is affected by their eating behavior as soon as the restrictive effect of the operations subsides.
{"title":"The impact of disordered eating and eating behavior on weight loss after sleeve gastrectomy in Egyptian adolescents","authors":"Mohey Elbanna , Amany Falah , Ahmed Magdy Hafez","doi":"10.1016/j.obpill.2025.100207","DOIUrl":"10.1016/j.obpill.2025.100207","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery is the most effective treatment for obesity in Adolescents. However, disordered eating is frequent in this population. Several studies found that disordered eating affects weight loss after bariatric surgery. The aim of this study was to find out the impact of disordered eating on weight loss in Egyptian adolescents two years after sleeve gastrectomy.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study conducted at Ain Shams University Hospitals from March 2020 to March 2024. It included 47 adolescents with obesity who underwent laparoscopic sleeve gastrectomy (LSG) two years before. Their age was 16.2 ± 0.67 years (range 14.5 – 17.8 years old). Their body mass indices were above 99th percentile for age and sex with or without comorbidities. They had a mean BMI of 39.9 kg/m² (range: 36.9 – 54.3 kg/m²). Patients with psychiatric illnesses and eating disorders were excluded. Patients were recruited after completion of two years of follow up for weight loss. Weight loss was evaluated by total weight loss % (TWL%). Disordered eating was detected by the Arabic version of EDE-Q v.6.0, and a global score of > 2.5 was considered positive. TWL% was correlated with EDE-Q score.</div></div><div><h3>Results</h3><div>After two years, the mean TWL% was 27.5% ± 7.7%. Nineteen patients (40.4%) had EDE-Q score more than 2.5. The EDE-Q positive patients had a mean %TWL of 25.7% ± 4.8%, while EDE-Q negative patients had a mean %TWL of 30.5% ± 6.2%. The difference is statistically significant.</div></div><div><h3>Conclusion</h3><div>We conclude that the outcome of sleeve gastrectomy in adolescents is affected by their eating behavior as soon as the restrictive effect of the operations subsides.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105018","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 : 2025-09-08DOI: 10.1016/j.obpill.2025.100209
Brittany V.B. Johnson, Mary Milstead, Rachel Kreider, Rachel Jones
Background
Recent advancements with Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) result in approximately 15 % or more weight reduction. Scientific research addressing specific nutritional concerns with GLP-1RA are still emerging. While some guidelines currently exist for nutritional considerations, they are largely focused on side effect management and providing basic dietary guidance during GLP-1RA.
Methods
This narrative review aims to provide practical evidence-based considerations for dietary supplementation to help optimize health outcomes while using GLP-1RA. We reviewed available literature of dietary supplementation interventions among individuals with obesity, weight loss clinical trials, and adiposity-related complications to help guide clinicians on potentially advantageous supplementation.
Results
Robust data from meta-analyses provides justification for a variety of dietary supplements that can support the unintended consequences of GLP-1RA treatments. Multivitamins are recommended to address micronutrient insufficiencies as determined by individual deficiencies and suboptimal intake. Protein supplements can help individuals meet daily protein intake recommendations of 1.2–2.0 g/kg/d. When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. Antioxidants and anti-inflammatory nutrients can mitigate oxidative stress and inflammation. Fiber and probiotics can improve bowel regularity and mitigate side effects.
Conclusion
Healthcare providers play an active role in supporting their patients with comprehensive obesity treatment. Guidance should focus on improving their long-term health and potentially mitigating unintended consequences. Optimizing nutrient intakes with therapeutic doses of dietary supplements may enhance outcomes when used alongside GLP-1RA, such as increasing nutrient status, retaining lean mass, reducing oxidative stress and inflammation, and improving gastrointestinal health.
{"title":"Dietary supplement considerations during glucagon-like Peptide-1 receptor agonist treatment: A narrative review","authors":"Brittany V.B. Johnson, Mary Milstead, Rachel Kreider, Rachel Jones","doi":"10.1016/j.obpill.2025.100209","DOIUrl":"10.1016/j.obpill.2025.100209","url":null,"abstract":"<div><h3>Background</h3><div>Recent advancements with Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) result in approximately 15 % or more weight reduction. Scientific research addressing specific nutritional concerns with GLP-1RA are still emerging. While some guidelines currently exist for nutritional considerations, they are largely focused on side effect management and providing basic dietary guidance during GLP-1RA.</div></div><div><h3>Methods</h3><div>This narrative review aims to provide practical evidence-based considerations for dietary supplementation to help optimize health outcomes while using GLP-1RA. We reviewed available literature of dietary supplementation interventions among individuals with obesity, weight loss clinical trials, and adiposity-related complications to help guide clinicians on potentially advantageous supplementation.</div></div><div><h3>Results</h3><div>Robust data from meta-analyses provides justification for a variety of dietary supplements that can support the unintended consequences of GLP-1RA treatments. Multivitamins are recommended to address micronutrient insufficiencies as determined by individual deficiencies and suboptimal intake. Protein supplements can help individuals meet daily protein intake recommendations of 1.2–2.0 g/kg/d. When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. Antioxidants and anti-inflammatory nutrients can mitigate oxidative stress and inflammation. Fiber and probiotics can improve bowel regularity and mitigate side effects.</div></div><div><h3>Conclusion</h3><div>Healthcare providers play an active role in supporting their patients with comprehensive obesity treatment. Guidance should focus on improving their long-term health and potentially mitigating unintended consequences. Optimizing nutrient intakes with therapeutic doses of dietary supplements may enhance outcomes when used alongside GLP-1RA, such as increasing nutrient status, retaining lean mass, reducing oxidative stress and inflammation, and improving gastrointestinal health.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048594","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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