Obesity Facts最新文献

Introduction: The association of hunger and weight status or weight change is unclear. We aimed to assess the cross-sectional and prospective associations between hunger levels and weight status and change.

Methods: Two surveys (2014-2017 and 2018-2021) from a prospective, population-based study were conducted in Lausanne, Switzerland. Ecological momentary assessments were used to assess hunger.

Results: There were 700 participants from the first survey (54.7% women, 60.6 ± 9.4 years), 40.4% with healthy weight, 38.9% overweight, and 20.7% with obesity. The corresponding values for the second survey (N = 775, 53.3% women, 65.1 ± 8.8 years) were 39.6%, 39.5%, and 20.9%. Participants with obesity had a smaller variation of hunger levels during the day (range 4.15 ± 0.08 vs. 4.38 ± 0.08 and 4.27 ± 0.07 vs. 4.35 ± 0.07 for participants with obesity and participants with healthy weight, respectively, in the first and second surveys, p for trend <0.05). Inconsistent associations were found regarding average or median hunger levels: for average: 2.35 ± 0.05, 2.34 ± 0.04, and 2.26 ± 0.06, p = 0.468 for participants with normal, overweight, and obesity, respectively, in the first survey and 2.38 ± 0.04, 2.39 ± 0.04, and 2.16 ± 0.06, p = 0.002, in the second survey. No association was found between hunger levels and abdominal obesity or between hunger levels and weight change after a 3.8-year follow-up.

Conclusion: Participants with obesity show a lower variability in hunger levels than healthy weight participants. Hunger levels are not associated with 3.8-year weight gain.

Introduction: Metabolic and bariatric surgery (MBS) leads to substantial muscle mass loss. Resistance training (RT) is an effective strategy to maintain muscle mass. This study aimed to gain insight into the motivators, barriers, and preferences that are correlated with RT uptake after MBS.

Methods: A digital survey assessing RT was sent to patients who had MBS 1-18 months prior. Patient characteristics were extracted from electronic health records. Motivators, barriers, and preferences were assessed with a questionnaire and compared across three groups: patients currently engaged in RT (RT-group), previously engaged in RT (ex-RT), or never engaged in RT (non-RT).

Results: Among 1,609 participants (77% female, 47 ± 11 years old, BMI 42 ± 5 kg/m2), 68% were classified as RT-group, 11% as ex-RT, and 21% as non-RT. The RT-group reported improving fitness (78% vs. 67%), mental health (65% vs. 43%), and overall health (63% vs. 41%) more often as motivators for RT than the ex-RT. RT barriers were comparable between ex-RT and non-RT, most frequently lack of motivation (37% vs. 40%), time (33% vs. 28%), enjoyment (29% vs. 29%), and physical complaints (39% vs. 37%). Ex-RT and non-RT reported a preferred exercise frequency of 2 sessions/week with 30 min/session, in their home setting with a training schedule and guidance from a professional.

Conclusion: The majority of participants in our study engaged in RT. We identified improving overall fitness and limiting strength or muscle loss as motivators, lack of motivation, physical complaints, lack of time and enjoyment as barriers, and professional guidance and a training schedule for RT at home as facilitators, which were correlated to RT uptake after MBS.

Introduction: Body mass index (BMI) is a risk factor for adverse consequences in chronic kidney disease patients. However, its impact on patients undergoing peritoneal dialysis (PD) remains uncertain. We conducted a comprehensive systematic review and meta-analysis to assess the impact of baseline BMI on PD outcomes.

Methods: All studies reporting outcomes of PD patients based on WHO-defined BMI groups were identified from PubMed, Embase, Scopus, and Cochrane Library databases up to March 30, 2025. Mortality, peritonitis rate, transfer to hemodialysis (HD), and technique failure were assessed.

Results: Eighteen studies were included. Meta-analysis of crude data showed a significantly increased risk of mortality in obese patients, while meta-analysis of adjusted data showed significantly higher mortality rates in underweight patients as compared to those with normal BMI. Comparisons of overweight and normal BMI patients for mortality remained nonsignificant. We noted a significant increase in the risk of peritonitis in obese patients but not in overweight or underweight patients. None of the groups demonstrated significant results for transfer to HD. Descriptive analysis showed that technique failure may not be significantly different across BMI groups.

Conclusions: Underweight PD patients seem to have a greater risk of mortality, while obese PD patients may have a higher risk of peritonitis. There seems to be no difference between the BMI groups for transfer to HD and technique failure. The high heterogeneity between studies limits strong conclusions.

Introduction: Obesity increases risk of several diseases and cognitive deficits. Bariatric surgery is the most effective treatment for severe obesity, leading to substantial weight loss and memory improvements. This study examines memory, weight loss, and pathological eating behaviors 5 years postoperatively in a sample of Norwegian bariatric surgery patients.

Methods: Memory, eating behaviors, and symptoms of depression and anxiety were assessed in 33 bariatric surgery patients (70% female, mean age 41.6 years) at baseline and 5 years after surgery. Self-report measures and standardized tests were used.

Results: Patients showed a mean weight loss of 25.7% (SD = 10.6) 5 years following surgery and significant improvement in verbal long-term memory. Weight loss correlated negatively with binge eating at 5-year follow-up, but not grazing. Baseline memory was the only significant predictor of 5-year memory function, accounting for 62% of the variance.

Conclusion: Finding suggests that bariatric surgery has long-lasting impact on long-term verbal memory. Binge eating was associated with less weight loss, while grazing had no significant impact. Regular monitoring of binge eating could be useful to identify patients in need of extended postoperative treatment and support.

Introduction: Genetic forms of obesity, including monogenic (MO) and syndromic (SO) obesity, are characterised by severe, early-onset weight gain due to disrupted central regulation of body weight, typically involving key pathways such as the leptin-melanocortin axis. These alterations result in marked hyperphagia and complex eating behaviours, yet clinical characterisation remains limited. This review aimed to describe the multidimensional eating behaviour profiles across genetically confirmed obesity, explore their variability, and evaluate existing assessment tools to support early diagnosis, personalised care, and therapeutic monitoring.

Methods: We conducted a systematic review following PRISMA guidelines including publications up to 4 September 2025. A total of 162 studies involving individuals with genetically confirmed SO or MO were analysed. Eating behaviours were categorised into nine dimensions: food-centred thinking, food-seeking/stealing, hunger/satiety, ingestive/oral behaviours, nutritional quality, food preferences, food acceptability, loss of control eating, and eating restraint. Assessment tools and methodologies were systematically reviewed.

Results: Hyperphagia was consistently reported across genetic aetiologies, though definitions and measures remain heterogeneous. Prader-Willi syndrome (PWS), the most studied condition, was associated with early-onset hyperphagia, increased hunger, pronounced food preoccupation, compulsive food-seeking/stealing and strong preferences for carbohydrate-rich, large quantities and unusual food items. Similar behavioural traits were found in other SO and MO, including Bardet-Biedl syndrome, Alström syndrome, Fragile X syndrome, WAGR syndrome, pseudohypoparathyroidism Ia, 16p11.2 deletion and LEPR, POMC, and MC4R deficiencies. Behavioural traits appeared relatively consistent across sex, age, and genotypes within syndromes. Most studies relied on caregiver reports; existing tools such as the Hyperphagia Questionnaire (HQ) and Food-Related Problem Questionnaire (FRPQ), developed primarily for PWS, did not fully capture the behavioural spectrum or suit all cognitive profiles. Tools applicable to individuals without intellectual developmental disorders, particularly adults living independently, remain scarce.

Conclusion: This is the first systematic review to comprehensively map eating behaviours across rare genetic obesity using a multidimensional approach. It highlights the shared feature of disrupted appetite regulation and emphasises the need for standardised, multidimensional tools suitable for both clinical and research contexts. Better behavioural characterisation will support targeted therapies and improve outcome monitoring in these high-need populations.

Introduction: This study assesses explicit weight bias (EWB) among French medical students and its association with demographic factors and educational tools.

Methods: A cross-sectional study assessed EWB among 1,635 students from two universities between June and September 2024. The Anti-Fat Attitudes Questionnaire measured three dimensions: dislike, fear of fat, and belief in weight controllability (willpower). Academic and demographic data were collected, with scores adjusted for sex. Two educational tools were evaluated: a podcast addressing weight bias ("Augusta's Oath") and a clinical rotation in the nutrition department.

Results: On a 1 to 9 scale where higher scores indicate stronger weight bias, medical students showed a moderate overall score (2.7 ± 1.1), with low levels of dislike toward individuals with obesity (1.9 ± 1.2), moderate belief in weight controllability (willpower, 3.1 ± 1.9), and high levels of personal fear of gaining weight (4.2 ± 2.1), indicating a persistent presence of EWB. Men exhibited higher EWB than women. Students who listened to the podcast had significantly lower willpower scores than those of non-listeners (2.6 ± 1.5 vs. 3.1 ± 1.7; p < 0.01) and were half as likely to score above 4, i.e., explicitly expressing bias (59/470; 12% vs. 279/1,164; 24%; OR: 0.50, 95% CI: [0.33; 0.74]; p < 0.01). Nutrition rotations were also associated with slightly lower willpower scores (2.8 ± 1.7 vs. 3.0 ± 1.7, p < 0.01). Neither educational exposure was associated with dislike or fear scores.

Conclusion: EWB, especially fear of getting fat and willpower beliefs, is prevalent among French medical students. Educational podcasts show promise in reducing specific biases, offering tools to combat weight stigma in medical education.

Introduction: Sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) are two of the three most performed metabolic and bariatric surgery (MBS) procedures worldwide. Indication for the proper surgical procedure is based on the surgeon's choice, and no validated score for procedure selection exists. The aim of this study was to develop and validate a clinical score, which standardizes procedure selection in MBS.

Methods: Based on the importance of obesity complications and comorbidities, we created a Metabolic Surgery Indication Score (MetSIS), including ten clinical and laboratory parameters to categorize the complex disease obesity with its comorbidities: age, sex, body mass index (BMI), obstructive sleep apnea syndrome (OSAS), hypertension, dyslipidemia, type 2 diabetes mellitus (T2DM), HbA1c, insulin therapy, and metabolic dysfunction-associated steatotic liver disease (MASLD). Minimum score was 0 points, and maximum 12 points. Retrospectively, data from all patients who underwent primary SG or OAGB in a 4-year period in our center of excellence for MBS were analyzed. Exclusion criteria included reflux disease (esophagitis ≥C next to LA classification) and/or the presence of hiatal hernia (≥3 cm) (since these patients undergo RYGB next to the internal protocol) and revisional bariatric surgery.

Results: From March 2019 to September 2023, 468 patients underwent SG (n = 363) or OAGB (n = 105) as primary bariatric procedure. Mean BMI was 42.1 kg/m2 (SG) and 48 kg/m2 (OAGB). Patients who underwent SG demonstrated lower MetSIS, while patients who underwent OAGB had a higher score (p < 0.001). The parameters BMI (p < 0.001), presence of OSAS associated with CPAP treatment (p < 0.001), hypertension (p < 0.001), T2DM (p < 0.001), insulin requirement (p = 0.001), and MASLD (p = 0.035) were found as statistically significant parameters which influenced procedure choice.

Conclusion: The MetSIS is a simple and immediate score, which can be applied during decision-making of MBS procedure in routine clinical settings. Further studies are necessary to associate this score to the real metabolic outcome during long-term follow-up.

Introduction: Visceral adipose tissue (VAT) is a significant driver for metabolic disease risk. Low-dose computed tomography (LDCT) imaging obtained for other clinical indications is useful for the opportunistic screening of osteoporosis and demonstrates additional potential for the screening of metabolic risk through the measurement of VAT. In this study, we explored LDCT-derived VAT and calculated VAT thresholds indicative of elevated metabolic risk in a population cohort of Chinese men and women.

Methods: A total of 21,772 adults (64.2% men, 35.8% women) received a LDCT chest scan for routine lung cancer screening between 2018 and 2019, and abdominal VAT area (L2 region) was derived from these scans using QCT software. The presence of metabolic syndrome (MetS) was ascertained from clinical records and based on the Chinese national guidelines. All data for this current study were obtained from the China Biobank Project, a prospective, nationwide, multicenter population study.

Results: MetS was prevalent in 29.5% of men and 10.5% of women. Using receiver operating characteristic (ROC) curves, we determined the optimum VAT area cut points for identifying MetS: 210 cm2 in men (odds ratio [OR] 6.15, 95% confidence interval [CI] 5.65, 6.69) and 136 cm2 in women (OR 9.25, 95% CI: 7.58, 11.4). A population attributable risk for MetS by VAT area above sex-specific cut points was 70.9% in men and 74.1% in women. The area under the ROC curves (AUCs) of VAT area for distinguishing MetS are 0.780 (95% CI: 0.772, 0.788) in men and 0.854 (95% CI: 0.842, 0.866) in women, both exceeding the AUCs for body mass index (BMI). ROC curves showed that VAT area demonstrates superiority over BMI and WC in identifying hypertension and hyperglycemia in men, as well as hypertension, hyperglycemia, and hypertriglyceridemia in women.

Conclusion: LDCT-based opportunistic measured VAT area is a superior predictor of metabolic risk, better than BMI and WC, and should be monitored and interventions made to control the metabolic risk. This study proposes VAT risk thresholds for the Chinese population: 210 cm2 for men and 136 cm2 for women.

Introduction: Bariatric surgery is increasingly proposed for grade 2 or 3 obesity, yet the failure rate remains around 20-25%. The role of psychological and nutritional factors in this unfavorable outcome remains controversial. This study investigates whether the existence of residual psycho-nutritional difficulties after well-managed preoperative care is associated with reduced effectiveness of bariatric surgery.

Methods: Between 2017 and 2020, 57 patients with residual psycho-nutritional difficulties after multidisciplinary preparation for bariatric surgery were included in this observational study. These patients were matched with 57 controls without such difficulties, based on age, sex, history of bariatric surgery, type of bariatric surgery planned, and date of validation of surgical indication. To prevent introducing bias into the routine follow-up process, the patients were not informed of the objective of the study. Weight was measured at the time of surgery and at 1, 6, 12, and 24 months after surgery. The percentage of excess weight loss (PEWL) was assessed using a linear mixed model.

Results: At 2 years, the mean PEWL was 70.2% (95% CI [59.6; 80.8]) in patients with residual psycho-nutritional difficulties, compared with 71.4% (95% CI [63.4; 79.4]) in the control group. The rate of change in PEWL over time did not differ significantly between groups in the multivariate model (p = 0.54). No significant difference was found in adherence to surgical follow-up, quality of life at one and 2 years, or evolution of diabetes and hypertension at 2 years.

Conclusion: Residual psycho-nutritional difficulties did not impact bariatric surgery outcome at 2 years. Therefore, these patients should not automatically be considered at higher risk of failure. Further follow-up at 5 years is ongoing.

Introduction: Insulin resistance is prominent in overweight/obesity. We examined if insulin action in fat cells predicts the outcome of therapeutic weight loss.

Methods: We investigated 93 adult Swedes with overweight/obesity (body mass index, BMI, 29-50 kg/m2) before and after hypo-energetic high- or low-fat diet for 10 weeks. At baseline, overall insulin resistance (homeostasis model assessment, HOMA-IR) and insulin action on lipolysis and lipogenesis in isolated abdominal subcutaneous fat cells were determined. The participants were divided into tertiles based on their values for the cellular insulin action parameters. The relationship to weight loss parameters (fat mass index, fat free mass index, or BMI) was examined by analysis of variance. The influence of baseline age, sex, waist-to-hip ratio, physical activity, and BMI was investigated by analysis of covariance. Because the body weight loss (on average 8 kg) did not differ between the diets their respective data were combined.

Results: The sensitivity (half-maximum effective hormone concentration) of the anti-lipolytic effect of insulin correlated with loss of BMI, body weight, and fat mass index (F ≥ 3.1; p ≤ 0.0495). Body weight loss was about 30% greater in those with highest compared with lowest anti-lipolytic insulin sensitivity, and it was independent of the cofactors mentioned above (F = 8-9; p = 0.004-0.005). However, HOMA-IR, maximum insulin induced anti-lipolysis or lipogenesis and insulin sensitivity of lipogenesis did not associate with loss of BMI or fat mass index.

Conclusion: A high anti-lipolytic insulin sensitivity in subcutaneous fat cells independently associates with pronounced weight loss following energy-restricted diet, whereas lipogenesis and overall insulin resistance are not related to weight change.