International Journal of Obesity最新文献

The Physiology Of the WEight Reduced State (POWERS) study is a multi-center clinical trial designed to understand the physiological basis for observed variability in weight regain following intentional weight loss among US adults. The primary dependent variable is weight regain over one year following a 7% or greater supervised weight loss. The overarching design and study organization, along with rationale and history of the POWERS study and outcomes measures are described in accompanying papers. This paper provides the rationale for and description of biospecimens samples that will ultimately inform on the molecular and cellular basis of the physiological variability that contributes to the regulation of energy balance in the weight reduced state. Participants will be 205 healthy adults (n = 205), aged 25-59 years, with body mass index (BMI) 30- ≤ 40 kg/m². Biospecimens will be collected prior to weight loss (baseline, BL), immediately following weight loss via lifestyle intervention (T0), and then four (T4) and twelve (T12) months after weight loss. Blood will be collected in the fasting state and following a meal challenge designed to induce hormones related to satiety. Weight change from T0 to T12 will be the primary outcome variable. Biospecimens to be collected include plasma, serum, peripheral blood mononuclear cells (PBMCs), DNA, urine, feces, adipose and skeletal muscle tissue. All samples will be biobanked at each site. This manuscript describes the rationale for the biospecimens chosen to assess contributors to homeostatic mechanisms that drive observed variability of weight regain after weight loss.

Introduction: The global rise in maternal obesity presents a growing public health challenge, with significant implications for pregnancy outcomes. This study offers a comprehensive retrospective analysis of changes in Body Mass Index (BMI) among pregnant women during labor over four decades.

Material and methods: BMI data were retrospectively collected from 13,193 pregnant women divided into three cohorts: Group 0 (1986-1990), Group 1 (2009-2013), and Group 2 (2024).

Results: Mean BMI increased significantly from 23.75 kg/m² in Group 0 to 27.33 kg/m² in Group 2 (p < 0.001). The prevalence of obesity rose more than fivefold, from 4.87% to 25.76%. Regression analysis confirmed a linear and statistically significant upward trajectory across all groups.

Conclusions: The sustained increase in maternal BMI underscores the urgency of implementing targeted interventions, including preconception counseling and personalized antenatal care, to mitigate the adverse maternal and neonatal outcomes associated with elevated BMI.

Background: Candidates for metabolic bariatric surgery (MBS) experience significantly higher rates of mental disorders compared to the general population. While previous studies have primarily focused on a limited range of mental health conditions, this study expands the scope by studying a broader spectrum of psychopathological symptoms. Our aim was to map the psychopathological profile of candidates for MBS and to test whether individuals higher in general psychopathology exhibit a higher body mass index (BMI) and more severe eating disorder symptoms than those lower in general psychopathology.

Methods: A total of 222 candidates for MBS from the Dutch Obesity Clinic completed 16 questionnaires to generate a comprehensive psychopathological profile. Cluster analysis was applied to identify distinct groups based on general psychopathology. The clusters were compared on BMI and eating disorder psychopathology. A cross-sectional network approach was used to explore the complex interconnections between symptoms.

Results: Two clusters emerged: a high psychopathology profile (high PP; 29%) characterized by elevated scores on general psychopathology, and a low psychopathology profile (low PP; 71%) marked by healthier psychological functioning. The high PP cluster exhibited more severe eating disorder psychopathology than the low PP cluster, while the clusters did not differ in BMI. The symptom network revealed that general psychopathology is linked to eating disorder psychopathology through the bridge symptom 'eating concerns.'

Conclusions: Approximately one-third of the individuals presenting for MBS exhibit elevated, transdiagnostic psychopathology with complex connections between symptoms. Notably, BMI was not associated with the severity of symptoms. The symptom network analysis highlights that 'eating concerns' serve as a crucial bridge linking eating disorder symptoms and symptoms of emotional disorders. Future research should focus on the transdiagnostic nature of psychopathology associated with obesity and investigate its potential impact on treatment outcomes, such as weight loss and quality of life.

Background: Obesity represents a critical global health challenge, yet the neurocognitive distinctions in processing different rewards among individuals with overweight/obesity (OW/OB) remain poorly characterized. This meta-analysis aims to synthesize functional MRI evidence to delineate common and distinct neural abnormalities during processing of food or monetary reward cues in individuals with OW/OB compared to normal-weight (NW) controls.

Methods: Searches were conducted in Web of Science, PubMed, and PsycInfo to identify eligible citations from inception until May 2025. The review protocol was registered in PROSPERO (No. CRD42024595608). Data analyses were carried out using the Activation Likelihood Estimation (ALE) algorithm. MRIcroGL was used to show the results with MNI coordinates.

Results: We systematically reviewed 26 studies with 1065 participants, comprising 6 monetary reward and 20 food reward studies. Overlapping reduced activation occurred in the left posterior cingulate cortex (PCC) and insula across both reward types; the left middle frontal gyrus (MFG) exhibited decreased activation in response to food reward cues, while it showed increased activation in response to monetary reward cues in individuals with OW/OB. During food-reward tasks, individuals with OW/OB exhibited increased activation in the bilateral caudate nucleus, hippocampus, anterior cingulate cortex (ACC), and medial prefrontal cortex, alongside decreased activation in amygdala responses. For monetary-reward tasks, increased activation was observed in the right lateral nucleus and hypothalamus, while decreased activation was observed in the right subthalamic nucleus (STN) and posterior ventral lateral nucleus.

Conclusion: Obesity represents a critical global health challenge, yet the neurocognitive distinctions in processing different rewards among individuals with OW/OB remain poorly characterized. Our findings reveal both dissociable and overlapping neural alterations during the processing of primary (food) versus secondary (monetary) rewards in OW/OB, implicating altered reward sensitivity, decision-making, and inhibitory control. The results underscore the necessity for reward-type-specific interventions targeting these neural mechanisms to address obesity-related dysregulation. Contrasts in brain activation during food and monetary reward processing between individuals with overweight/obesity (OW/OB) and normal weight (NW).

Background: Metabolic and bariatric surgery (MBS) is a highly effective treatment for patients with obesity, with increasing prevalence in France. However, some patients require revisional MBS (RMBS) due to suboptimal initial response, recurrent weight gain, and correction of technique-related complications. Understanding the prevalence and risks associated with RMBS is essential for optimizing patient care.

Objective: This study aims to assess the rate of RMBS in France and to delineate the associated complications and risk factors.

Setting: France.

Methods: Using national discharge data from 2016 to 2022, this observational study compared morbidity and mortality rates between primary and RMBS. Patient demographics, comorbidities, and procedural details were analyzed. Major complications within 90 days post-surgery were assessed using logistic regression models adjusted for potential confounders.

Results: Among 284,271 bariatric procedures analyzed, the revision rate was 12.8%. Patients undergoing RMBS were older, predominantly female, and had more comorbidities compared to those undergoing primary procedures. RMBS were associated with significantly higher rates of severe complications (OR 1.58, 95% CI 1.49-1.68, p < 0.001), particularly after gastric bypass (GB) (OR 2.70, 95% CI 2.27-3.20). Subgroup analyses showed increased morbidity following revisional sleeve gastrectomy compared to primary procedures.

Conclusions: This study highlights a notable rate of RMBS in France, with evolving trends towards more complex revisions. RMBS are associated with increased morbidity, emphasizing the need for careful patient selection and enhanced postoperative management. Further research into surgical techniques, long-term pharmacological interventions, and surgeon expertise is warranted to optimize outcomes in this population.

Background/objective: There is evidence that living with obesity can affect an individual's pay and employment, but there is little evidence on the impact of weight-management interventions in improving labour market outcomes of individuals. We evaluate the impact of bariatric surgery on monthly earnings and employee status among working-age adults, and examine variations across sociodemographic characteristics.

Methods: This population-based, retrospective longitudinal cohort study for England included 40,662 individuals who had a bariatric surgery procedure and obesity diagnosis between 1 April 2014 and 31 December 2022, with no bariatric surgery history in the previous 5 years, and were 25 to 64 years old at the date of surgery. 49,921 individuals sampled from the general population who had not had bariatric surgery were also included, matched by age and sex. The main outcome measures were monthly employee pay-for all months and only months where the individual was in paid employment-expressed in 2023 prices and paid employee status.

Results: Among people living with obesity who had bariatric surgery, there was a sustained increase in monthly employee pay from 6 months after surgery with a mean increase of £84 per month (95% confidence interval [Cl]: 63-106) 5 years after surgery compared with the 6 months before surgery. There was a sustained increase in the probability of being a paid employee from 4 months after bariatric surgery, with a mean increase of 4.3 percentage points (95% Cl: 3.7-4.9) 5 years after surgery.

Conclusion: Bariatric surgery is associated with an increased probability of being employed, resulting in increased earnings. This suggests that living with obesity negatively impacts labour market outcomes and that obesity management interventions are likely to generate economic benefits both to individuals and on a macroeconomic level by increasing the likelihood of employment of people living with obesity.

Background: Glucosylsphingosine (Lyso-GL-1), a glycosphingolipid formed by glucosylceramide hydrolysis, is known to be increased in Gaucher disease. Recently, increased ceramides and sphingolipids have been implicated in obesity, insulin resistance, and atherogenesis. However, limited data exists on serum Lyso-GL-1 level in children with obesity and its relation with insulin resistance, lipid dysfunction, and atherogenesis. Hence, this study aimed to assess Lyso-GL-1 level among children with obesity and correlate it with biomarkers of insulin resistance and atherogenic index of plasma (AIP).

Methodology: Sixty children with obesity with a mean age of 10.06 years (SDS ± 2.22) and 60 age- and sex-matched normal-weighed controls were assessed for anthropometric measures, mean blood pressure percentiles, serum Lyso-GL-1, glycated hemoglobin (HbA1c), fasting insulin, triglycerides, cholesterol, low-density (LDL-C) and high-density lipoprotein cholesterol (HDL-C) with calculation of the homeostatic model assessment of insulin resistance (HOMA-IR) and the AIP.

Results: Children with obesity have significantly higher Lyso-GL-1 and AIP than controls. Lyso-GL-1 is significantly positively correlated with body mass index (BMI) z-score, waist/hip ratio z-score, systolic and diastolic blood pressure percentiles, LDL-C, HOMA-IR, and AIP (p < 0.05), being independently correlated with systolic blood pressure percentile, LDL-C, and AIP on multivariate regression analysis.

Conclusion: Serum Lyso-GL-1 is elevated in children with obesity, being closely correlated with hypertension, insulin resistance, and atherogenesis. This could provide a mechanistic insight on the role of Lyso-GL-1 in obesity and atherogenesis. Further studies are warranted to explore the potential role of Lyso-GL-1 as a biomarker and target for the prevention and treatment of obesity-related atherogenesis and insulin resistance.

Objective: The objective of our 14-day technology-supported free-living study was to assess how psychological, environmental, and social factors affect overeating among participants with obesity.

Methods: We recruited 47 adults with obesity (BMI ≥ 30 kg/m²), who collectively logged 2004 meals, wore and used study devices for meal verification, and completed daily food recalls administered by dietitians. Participants reported on stress, affect, hunger, and meal contexts through Ecological Momentary Assessments (EMA). To explore the factors influencing caloric intake per meal, we employed a two-level mixed-effects location scale model, capturing both between-subject (BS) and within-subject (WS) factors based on the EMA data. This is a secondary analysis of the SenseWhy study, focusing on the association between stress and intake.

Results: Our analysis identified six BS factors (e.g., stress, perception of overeating, restaurant food, later meals, pleasure-seeking meal) and ten WS factors (e.g., biological hunger, perceived overeating, uncontrolled eating, social eating, restaurant food, snacks) to be significantly associated with caloric intake. Notably, participants who were more stressed, on average, consumed more calories (0.74; p = 0.002) with high consistency (-0.7; p = 0.048) between individuals. When stressed and not at home, participants consumed less calories (-0.62; p = 0.0043).

Conclusion: Conventional strategies for managing stress-related overeating fall short. Effectively addressing overeating requires an understanding of both psychological and contextual factors.