Obesity Facts最新文献

Introduction: To improve pediatric obesity treatment, this study aimed to identify predictors of body weight loss (BWL) and its maintenance (BWLM) in children and adolescents.

Methods: Data from 59 hospitalized children and adolescents with obesity (aged 9-17, mean 13.4 ± 1.9 years; mean length of stay: 38 ± 9.1 days) were collected at admission (T1), at discharge (T2), and up to 24 months thereafter (T5). Predictors of BWL (ΔT1-T2) (mean 0.33 ± 0.14 BMI z-score) and BWLM (ΔT2-T5) were categorized into demographic, psychometric, and sociometric data, physical condition, autonomic nervous system functions, and eating behavior. Secondary outcomes included changes in body composition and motor performance. Predictors were analyzed using LASSO [Journal of the Royal Statistical Society. 1996;58(1):267-288] and hierarchical regression.

Results: Energy density and food intake consistently predicted BWL and BWLM. Body dissatisfaction (p = 0.016), better anger management (less anger-related emotion regulation in the Stress and Stress Coping Questionnaire) (p = 0.031), smell identification skills, higher initial motor performance and strength, and lower initial endurance predicted BWL. A positive attitude toward healthy eating (p < 0.001), its improvement over time (p = 0.027), lower parasympathetic withdrawal - indicated by a smaller relative change in Root Mean Square of Successive Differences (RMSSDs) from baseline to stress (%RMSSD change, p = 0.022) - and high salt sensitivity (p < 0.001) significantly predicted BWLM.

Conclusion: This study provides initial indications that energy intake, in interaction with psychological and physiological factors, may be relevant to understanding BWL and BWLM in pediatric obesity, warranting further investigation.

Introduction: Obesity is a chronic, progressive, and recurring disease that contributes significantly to multi-morbidity across Europe. Despite the publication of numerous clinical practice guidelines (CPGs) for obesity, many chronic disease guidelines for obesity-related diseases such as diabetes, MASLD, heart disease, and obstructive sleep apnoea do not integrate contemporary understandings of obesity as an adiposity-based disease requiring direct management in its own right. The objective of this qualitative content analysis was to evaluate the extent to which recent chronic disease CPGs align with current evidence-based obesity guidance.

Methods: A working group convened by the European Association for the Study of Obesity reviewed 13 chronic disease CPGs published since 2019. Guidelines were assessed using nine predefined criteria based on leading obesity CPGs. Data were extracted, and content analysis was used to identify gaps and opportunities across the chronic disease CPGs.

Results: Three key themes were identified: (1) inconsistent scientific/medical conceptualization of obesity, (2) limited integration of evidence-based obesity management guidance, and (3) minimal inclusion of person-centred care principles. Most guidelines treated obesity as a risk factor, not a disease, and lacked reference to contemporary obesity frameworks or person-first language.

Conclusion: Greater alignment across CPGs is essential to improve obesity care within multi-morbidity management. Collaborative, cross-speciality approaches are recommended to harmonize clinical guidance and promote integrated, stigma-free care.

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.