Current Obesity Reports最新文献

Purpose of review: This review summarizes the potential of targeting ferroptosis-iron-dependent lipid peroxidation-as a novel strategy for treating obesity and its metabolic complications through mechanisms different from traditional interventions.

Recent findings: Recent preclinical studies show that selectively inducing ferroptosis in lipid-rich adipocytes and obese mice can effectively decrease fat mass and enhance metabolic health. These ferroptosis-based methods target the fundamental cellular processes of adipocyte dysfunction, affecting lipid metabolism and reducing oxidative stress. The strategy appears promising in addressing major metabolic issues such as insulin resistance and hepatic steatosis. In addition, the ability to customize ferroptosis inducers based on individual metabolic profiles offers a pathway to highly personalized obesity treatments. Ferroptosis agonists offer a revolutionary therapeutic approach for obesity treatment by directly reducing fat mass and targeting key metabolic issues. However, applying these findings in clinical settings requires careful evaluation of the long-term safety and effects of pharmacological ferroptosis induction. This review highlights important gaps in current knowledge and suggests future research directions crucial for developing these innovative therapies.

Purpose of review: This review explores the integration of semaglutide, a highly effective glucagon-like peptide-1 receptor agonist (GLP-1RA), with medical nutritional therapy (MNT) for the comprehensive management of obesity. Semaglutide promotes significant weight loss and metabolic improvement, but optimal outcomes often require combining this pharmacological treatment with tailored nutritional interventions. This review focuses on two prominent dietary strategies whose nutritional profiles may complement semaglutide's mechanisms of action: the Mediterranean diet (MD) and very-low-energy ketogenic therapy (VLEKT).

Recent findings: The MD emphasises balanced macronutrients and anti-inflammatory components, making it particularly suitable for individuals with uncomplicated obesity; it supports gradual and sustainable weight loss while mitigating inflammation and gastrointestinal side effects. Conversely, VLEKT, which induces nutritional ketosis, may be more appropriate for patients with significant cardiometabolic comorbidities, offering rapid and substantial fat mass reduction and improved glycaemic control. Both dietary approaches, when integrated with semaglutide therapy, have the potential to preserve lean body mass, reduce gastrointestinal adverse events, and enhance adherence through improved satiety and tolerability. The proposed integrated approach underscores the importance of personalised nutritional strategies guided by patient-specific metabolic, hormonal, and microbiota profiles, and calls for effective multidisciplinary collaboration among nutritionists, endocrinologists, and behavioural health professionals to optimise therapeutic outcomes. Ultimately, we emphasise that shifting the clinical focus from weight reduction alone to a targeted approach integrating semaglutide with evidence-based nutritional strategies may represent the most promising pathway towards sustainable obesity management.

Introduction: Obesity is a major public health issue in the U.S., with Black women disproportionately affected. Structural barriers like poverty, limited healthcare access, and lower education hinder weight management. Telehealth may improve health equity, but its effectiveness versus in-person care for Black women with obesity is unclear. This review compares both approaches to guide equitable care.

Methods: We conducted a PRISMA-compliant systematic review and meta-analysis, searching PubMed, Embase, and Cochrane through April 2025. Eligible were randomized controlled trials (RCTs) compared remote ± in-person vs. in-person weight-loss interventions among Black women with obesity. Random-effects models pooled changes in weight, BMI, blood pressure, and lipids. Risk of bias was assessed with RoB-2, and GRADE evaluated evidence certainty.

Results: Four RCTs (N = 576) were included. The analysis found no statistically significant differences in primary outcomes of weight change (SMD - 0.22, 95% CI: - 0.68; 0.24), percentage weight loss (SMD - 0.80, 95% CI: - 3.86; 2.26), and BMI (SMD - 0.26, 95% CI: - 1.61; 1.11). Secondary outcomes, such as blood pressure and lipid profiles (HDL, LDL, total cholesterol, triglycerides), also showed no statistically significant difference across intervention formats. Risk of bias was generally low, but evidence certainty ranged from moderate to very low.

Conclusion: Remote weight-loss interventions via telehealth showed no significant short-term differences compared with in-person programs among Black women with obesity. Telehealth may offer a comparable alternative, but small sample size and limited follow-up preclude firm conclusions. Larger, longer-term, and culturally tailored trials are needed to confirm long-term impact and address digital equity.

Purpose of review: Eating disorders among children and adolescents occur in all body sizes and must be properly identified and treated across settings for optimal health outcomes. This review summarizes considerations for behavioral, pharmacological, and surgical obesity treatment and eating disorder risk.

Recent findings: Obesity and eating disorders share many common risk factors. Yet adolescents with obesity and eating disorders are underrepresented in research studies and often remain undiagnosed in medical practice despite presenting with more severe symptoms. There is evidence for reduction of subclinical disordered eating attitudes and behaviors in health behavior and lifestyle trials, with emerging evidence of reductions in subclinical disordered behaviors (i.e., loss of control eating) for patients who have undergone bariatric surgery. There is a paucity of eating disorder screening and monitoring data reported in pharmacological trials. Psychosocial outcomes, including subclinical eating disordered attitudes and behaviors, suicidality risk, and symptoms of depression and anxiety, should be continuously monitored prior to and throughout obesity treatment. There are several validated measures to detect symptoms of disordered eating among youth with higher weights. Early detection of eating disorder symptoms among obesity treatment-seeking youth is imperative to inform the course of comorbid treatment to occur simultaneously, sequentially, or within specialty care. Adolescents with obesity are at greater risk for engaging in disordered eating and related worsened mental and physical health outcomes compared to peers without obesity. It is vital to assess for eating disorder symptoms and presentation to inform timely treatment.

Purpose of review: The current review aimed to (1) synthesize information regarding the association between emotional eating (EE) and BMI, as well as between EE and dietary intake and psychological symptoms; (2) describe factors thought to underlie and/or maintain EE; and (3) summarize recent evidence supporting behavioral treatments of EE in people with obesity.

Recent findings: Adults with obesity frequently report EE. Emotion regulation and learning principles are key variables that may influence EE in adults with obesity. Behavioral treatments show promise for decreasing EE, in the short-term, especially cognitive-behavioral and mindfulness-based approaches. Although psychosocial factors are critical to the understanding of EE mechanisms and treatment, limitations include measurement of EE and construct definitions of proposed theoretical variables. Additionally, behavioral interventions overlap which obscures the relative utility of treatment components. Future work should clarify causal mechanisms of EE in the context of obesity to inform treatment development.

Purpose of review: This review aims to comprehensively examine the relationship between environmental pollution and obesity by integrating epidemiological evidence, biological mechanisms, and anthropometric measurements. It specifically focuses on how pollutants contribute to weight gain and metabolic disruptions, particularly in vulnerable populations.

Recent findings: Environmental pollution, including air, noise, light, persistent organic pollutants, and microplastics/plastic additives, is increasingly recognized as a contributor to the global obesity epidemic. Epidemiological studies highlight the associations between pollution exposure and obesity risk, while mechanistic research reveals how pollutants disrupt metabolic processes, alter hormonal balance, and induce systemic inflammation. This review synthesizes current findings on the role of environmental pollutants in obesity, integrating both epidemiological and mechanistic perspectives. It explores how exposure to pollutants disrupts metabolic pathways, alters endocrine functions, and promotes systemic inflammation, ultimately contributing to obesity. Vulnerable groups, such as pregnant women, children, adolescents, and the elderly, are particularly at risk due to their heightened sensitivity to environmental exposures. By highlighting critical research gaps, it underscores the need for further longitudinal studies and interventional strategies aimed at mitigating pollution-induced metabolic risks. Public health policies targeting environmental pollution could serve as an effective approach to obesity prevention and control.

Purpose of the review: This review aimed to summarize current evidence on the effectiveness of medical nutrition therapy (MNT) in the management of obesity and endometriosis, with a focus on dietary patterns such as the Mediterranean and Ketogenic diets, as well as nutritional supplementation. Additionally, it highlights the central role of the clinical nutritionist in implementing individualized, evidence-based interventions within multidisciplinary care.

Recent findings: Although the literature reports the existence of an inverse relationship between risk of endometriosis and body mass index, clinical evidence jointly reports that a condition of obesity is associated with greater disease severity. This, therefore, implies the need to identify the different phenotypes of patients with endometriosis at which to target a precision MNT. Several dietary patterns and supplements have been investigated for their role in endometriosis management. The Mediterranean diet-rich in anti-inflammatory nutrients, fiber, and antioxidants-has been associated with decreased pain and improved quality of life. More recently, ketogenic diets have shown potential in modulating insulin signaling and inflammatory pathways, though clinical evidence remains limited. Supplementation with omega-3 fatty acids, N-acetylcysteine, resveratrol, vitamins C and E, and probiotics has demonstrated promising anti-inflammatory and antioxidative effects in both preclinical and clinical studies. Furthermore, attention is being directed toward the gut microbiota and its interaction with the immune and endocrine systems in women with endometriosis. Endometriosis is a chronic gynecological condition characterized by ectopic endometrial tissue, estrogen dependence, and persistent inflammation. It affects approximately 10% of women of reproductive age and is associated with pelvic pain, infertility, and reduced quality of life. While conventional treatment focuses on hormonal therapy and surgery, MNT is emerging as a non-invasive, supportive approach. Nutritional interventions can target key pathophysiological mechanisms of endometriosis, such as systemic inflammation, oxidative stress, and hormonal imbalance, offering potential symptom relief and improved clinical outcomes.

Purpose of the review: This review summarizes recent evidence highlighting the specific role of adipose tissue in the systemic effects of incretin agonist-based drugs used in the treatment of obesity.

Recent findings: The development of incretin agonist-based drugs has achieved unprecedented success in the pharmacological treatment of obesity and the improvement of obesity-related comorbidities. While initially shown to significantly reduce adipose tissue through decreased food intake, incretin-based therapy is also increasingly reported to alter the properties of adipose tissue. Recent experimental and human studies indicate that these anti-obesity drugs induce significant changes in the metabolism and inflammatory state of adipose tissue, while also promoting its thermogenic plasticity. The direct and indirect actions of incretin-based anti-obesity drugs, which modify the properties of adipose tissue, are emerging as key contributors to the systemic health benefits of these treatments.

Purpose of review: Patients who undergo metabolic and bariatric surgery (MBS) are advised to increase physical activity (PA) to help minimize weight recurrence. This report reviews current evidence for this recommendation and offers suggestions for advancing future research.

Recent findings: Most observational studies suggest a link between higher PA and lower weight recurrence, yet they often rely on cross-sectional designs, making it difficult to determine the direction of this relationship. Randomized intervention trials remain limited, and current strategies may not sufficiently address the motivational barriers that hinder patients from sustaining higher PA levels. While some initiatives to address these gaps are in progress, further research should focus on approaches that accurately capture nadir weight to measure weight recurrence, clarify whether PA is more effective at preventing or treating weight recurrence, explore interventions beyond exercise-centric strategies, examine individual differences in response to PA, and include other relevant clinical and patient-centered outcomes.

Purpose of review: This narrative review aims to critically summarize evidence on the potential contribution of cytokines, including members of the tumor necrosis factor (TNF) superfamily, interleukins (ILs), interferons (IFs), chemokines, lymphokines, and members of the transforming growth factor (TGF) superfamily to the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD). It also considers the translational relevance of cytokines, including their potential for non-invasive biomarkers or therapeutic targets of MASLD.

Recent findings: MASLD and its inflammatory phenotype, metabolic dysfunction-associated steatohepatitis (MASH), are characterized by chronic, low-grade hepatic inflammation, primarily initiated by metabolic contributors and driven by various cytokines. Cytokines are major mediators of the transition from hepatic steatosis to MASH. Some of them seem to be predominantly protective (tumor necrosis factor weak inducer of apoptosis, IL-10, IL-22, IL-25, IL-27), others appear to exhibit a possibly dual-faceted effect, depending on the stage of MASLD (TNF-α, TNF-related apoptosis-inducing ligand, IL-2, IL-6, IL-18, IL-33, IFNs), whereas a third group of cytokines seems to be predominantly harmful, thus driving the progression of hepatic steatosis to MASH, fibrosis, cirrhosis, and possibly to hepatocellular carcinoma. In this regard, some cytokines may prove suitable non-invasive indices for distinguishing MASH or hepatic fibrosis from hepatic steatosis. Additionally, cytokine-based therapies, including anti-TNF-α agents (infliximab, adalimumab, etanercept), NLRP3 inhibitors, recombinant IL-1R antagonist (anakinra), selective C-C chemokine receptor type 2 inhibitors, anti-IL-17 (e.g., secukinumab and ixekizumab) or IL-17R (brodalumab) monoclonal antibodies, and recombinant IL-22, may prove promising pharmacological targets for the management of MASLD. Amounting evidence renders some cytokines key players in the pathophysiology of MASLD, which may possibly have diagnostic and therapeutic implications.