Clinical Obesity最新文献

M. C. Chong, T. Y. L. Ko, P. L. le Roux, and C. W. le Roux, “Changes in Eating Behaviour During Treatment With Obesity Medications,” Clinical Obesity 16, no. 1 (2026): e70065, https://doi.org/10.1111/cob.70065.

Carel W. le Roux has also been added as a corresponding author.

We apologize for these errors.

Two Brazilian medical societies have proposed a new classification of obesity based on the maximum weight attained in an individual's lifetime, to be used in the clinical evaluation of individuals undergoing obesity treatment. This classification, which applies to adults aged 18 to 65 years, categorises people with obesity (PwO) who lose a certain percentage of their weight as having either ‘reduced’ or ‘controlled’ obesity. While the classification aims to improve patient care, there is limited data on PwO perceptions. To explore this, a cross-sectional online survey was conducted with 500 PwO, including an explanation and clinical case of the new classification. The survey revealed that 64% of participants had never been asked by a healthcare professional (HCP) about their maximum weight. After knowing the new classification, 82% found it useful for changing perceptions about obesity treatment; 66% felt it would encourage them to seek treatment; 63% believed it would help with treatment maintenance; and 74% indicated they would feel better achieving ‘controlled obesity,’ even if the weight loss fell short of their goals. A majority agreed that the classification could help establish realistic goals (77%) and reduce biases from HCPs (69%). Overall, PwO perceived the classification as beneficial for encouraging treatment and reducing stigma.

Overweight and obesity are estimated to affect more than 40% of adults in the Asia-Pacific (APAC) region. This study used a cross-sectional online survey to assess the impact of obesity on health-related quality of life (HRQOL) using the Impact of Weight on Quality of Life (IWQOL)-Lite instrument and willingness to pay for obesity management among adults with body mass index (BMI) ≥ 18 kg/m² in Australia, India and South Korea. A total of 2952 adults completed the survey. Most respondents (82%) were concerned with their weight, increasing with obesity class. Rated on a scale of 0–100 (worst to best quality of life), the mean (SD) overall IWQOL-Lite score was 61 (30) with no differences by gender. The mean lowest score was in the self-esteem domain, with female respondents reporting greater impairment than male respondents (47 vs. 53, p < 0.05). Total IWQOL-Lite and domain scores declined with increasing weight class (mean of 81 for individuals with normal weight to 35 for those with Obesity Class III). Of the 1752 individuals living with obesity, 80% would be willing to pay USD $25 per month for a weight loss method requiring minimal/moderate changes to diet, exercise and lifestyle that would enable them to achieve weight loss in 1 year; nearly half were willing to pay USD $225 per month. Our study highlights the negative impact of weight on the HRQOL of individuals in three APAC countries and the willingness to pay to achieve weight loss.

Obesity is a chronic, relapsing disease influenced by biological, environmental and behavioural factors. Pharmacological therapies have demonstrated substantial effects in weight loss, appetite suppression and modulation of food-related thoughts; however, the long-term effects of medications and eating behaviours across treatment phases throughout time remain poorly understood. This qualitative study involves 31 semi-structured interviews exploring patients in the dynamic and stable phase of weight loss. The interviews were conducted, transcribed, then analysed thematically. The five main themes that emerged were hunger, fullness, thoughts of food, portion size and palatability. The dynamic phase reported profound appetite suppression, early fullness, reduced ‘food noise’ with diminished cravings and smaller portion size. Portion control remained a persistent behavioural change across both phases. Long-term goals shifted from weight loss in the dynamic phase to weight maintenance in the stable phase. This transition is best described as a spectrum of change rather than a strict dichotomy. With a perceived loss of efficacy, some also report consideration of switching medications, especially in the stable phase. Overall, this cross sectional, patient-centred qualitative study may change practice of prescribers, policymakers, and the focus of future research.

Despite substantial benefits of metabolic and bariatric surgery (MBS), up to 1 in 5 patients develop an alcohol use disorder (AUD) within 5 years post-operatively. Cognitive-behavioural processes that are relevant to the reinitiation and escalation of alcohol use post-MBS are not well understood. Through content analysis of 20 patient interviews, we explored the course of alcohol use among individuals 6 months to 5 years post-MBS and examined potential differences by level of use. Over half (55%) of the participants reported high alcohol use, most described a gradual reintroduction to alcohol post-MBS, and escalation to misuse was thought to occur at an accelerated pace (i.e., potentially within months). Pre-operative intentions, attitudes/beliefs about post-MBS alcohol use, social factors, mood, visual cues, and post-MBS biological changes were reported to influence the course of post-MBS alcohol use. Although most features did not differ widely between those with higher versus lower alcohol consumption, reinitiating alcohol less than 12 months post-operatively and certain attitudinal factors (i.e., minimising the risks) may relate to greater alcohol use post-MBS. Findings illustrate the importance of early and long-term monitoring of post-MBS alcohol use. Several implications for early intervention and future research are discussed.

Adiposity contributes to multiple non-communicable diseases. To guide prevention of morbidity, this study aimed to quantify the relation between waist circumference (WC), body mass index (BMI), waist to height ratio (WtHR), abdominal subcutaneous (SAT) and visceral adipose tissue (VAT) and the risk of a composite outcome including recurrent cardiovascular events, incident type 2 diabetes and incident cancer, as well as each individual disease and all-cause mortality. Data were used from the UCC-SMART cohort study from 6138 patients with cardiovascular disease. Cox proportional hazard models estimated hazard ratios (HRs) and 95% confidence intervals (95% CIs) for adiposity measures, modelled as quartiles and per 1 SD increase, in relation to disease outcomes. All adiposity measures, except SAT, were related to higher risk of the composite outcome. WC and VAT showed the strongest relation (HR 1.62, 95% CI: 1.43, 1.83 and 1.62, 95% CI: 1.44, 1.83, respectively). Only WC and VAT were related to all-cause mortality (HRs 1.17, 95% CI: 1.01, 1.37 and 1.26, 95% CI: 1.08, 1.46, respectively). In patients with cardiovascular disease, WC and VAT are most strongly related to the risk of the composite outcome and to all-cause mortality. Monitoring adiposity with WC and VAT may help identify high-risk patients and could guide earlier interventions.