Alexandrine Robert, Hugo Guillermou, Patrick Lefebvre, Valérie Lacroix, Christine Bourrie-Coron, Sylvie Gateau, Brigitte Daynes, Marie Christine Picot, Audrey Jaussent, David Nocca, Florence Galtier
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.
{"title":"Association between Residual Psycho-Nutritional Difficulties and Percentage of Excess Weight Loss 2 Years after Bariatric Surgery: A Controlled Observational Study.","authors":"Alexandrine Robert, Hugo Guillermou, Patrick Lefebvre, Valérie Lacroix, Christine Bourrie-Coron, Sylvie Gateau, Brigitte Daynes, Marie Christine Picot, Audrey Jaussent, David Nocca, Florence Galtier","doi":"10.1159/000547948","DOIUrl":"10.1159/000547948","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-8"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Daniel P Andersson, Thorkild I A Sørensen, Peter Arner
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.
{"title":"The Anti-Lipolytic Effect of Insulin in Adipocytes Associates with the Magnitude of Dietary Induced Loss in Body Weight and Fat Mass: A Longitudinal Study.","authors":"Daniel P Andersson, Thorkild I A Sørensen, Peter Arner","doi":"10.1159/000547949","DOIUrl":"10.1159/000547949","url":null,"abstract":"<p><strong>Introduction: </strong>Insulin resistance is prominent in overweight/obesity. We examined if insulin action in fat cells predicts the outcome of therapeutic weight loss.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-9"},"PeriodicalIF":4.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Overweight and obesity are linked to an elevated risk of numerous serious diseases and health conditions. Despite the detrimental effects associated with these conditions, recent studies have indicated that critically ill patients may experience a survival advantage with higher body mass index. Initial research on the obesity paradox primarily concentrated on cardiovascular diseases (CVDs), such as heart failure (HF); however, this focus has now expanded to encompass other critical illnesses, particularly sepsis, Acute Respiratory Distress Syndrome (ARDS), trauma, and others. Although the obesity paradox has been extensively documented in research, its origins and implications remain subjects of contentious debate.
Summary: This review elucidates the phenomena and underlying mechanisms supporting the obesity paradox, critically examines recent evidence regarding this paradox in severe diseases, and aims to enhance prognostic assessments and therapeutic strategies in clinical practice.
Key messages: The obesity paradox exists in multiple kinds of critically ill patients caused by such as sepsis, lung diseases, and CVD. Even obesity does not protect obese patients; it has no association with mortality.
{"title":"Obesity Paradox in Critically Ill Patients: Do Patients with Critical Diseases Benefit from Obesity?","authors":"Yingying Wang, Dan Li, Lungang Zhu","doi":"10.1159/000547813","DOIUrl":"10.1159/000547813","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity are linked to an elevated risk of numerous serious diseases and health conditions. Despite the detrimental effects associated with these conditions, recent studies have indicated that critically ill patients may experience a survival advantage with higher body mass index. Initial research on the obesity paradox primarily concentrated on cardiovascular diseases (CVDs), such as heart failure (HF); however, this focus has now expanded to encompass other critical illnesses, particularly sepsis, Acute Respiratory Distress Syndrome (ARDS), trauma, and others. Although the obesity paradox has been extensively documented in research, its origins and implications remain subjects of contentious debate.</p><p><strong>Summary: </strong>This review elucidates the phenomena and underlying mechanisms supporting the obesity paradox, critically examines recent evidence regarding this paradox in severe diseases, and aims to enhance prognostic assessments and therapeutic strategies in clinical practice.</p><p><strong>Key messages: </strong>The obesity paradox exists in multiple kinds of critically ill patients caused by such as sepsis, lung diseases, and CVD. Even obesity does not protect obese patients; it has no association with mortality.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-12"},"PeriodicalIF":4.7,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Han Wang, Yang Xiao, Lina Han, Guorong Lyu, Shu Lin, Shi-Lin Li
Background: Sarcopenic obesity (SO), characterized by the coexistence of reduced skeletal muscle mass and increased fat mass, impairs physical function and mental health. It is commonly associated with comorbidities such as atherosclerotic heart disease, diabetes mellitus, and hypertension. These conditions elevate the risk of osteoporosis and fractures, which may serve as early clinical indicators of SO. With global economic development and an aging population, the prevalence of SO is rising rapidly.
Summary: This narrative review explores recent advances in the clinical diagnosis of SO, with a particular focus on the application of auxiliary imaging techniques in both qualitative and quantitative assessments. The review synthesizes findings from current clinical research and evaluates the role of imaging tools in improving diagnostic accuracy and treatment strategies for SO. Despite significant progress, challenges remain in terms of accessibility, cost-efficiency, and practical implementation of these technologies in routine clinical practice.
Key messages: SO is a growing public health concern due to population aging and increasing comorbidities. Diagnostic imaging plays a vital role in enhancing the detection and management of SO. There is a pressing need to develop affordable and accessible diagnostic tools to meet clinical demands.
{"title":"Advancements in Clinical Diagnosis and the Application of Auxiliary Imaging in Sarcopenic Obesity.","authors":"Han Wang, Yang Xiao, Lina Han, Guorong Lyu, Shu Lin, Shi-Lin Li","doi":"10.1159/000547689","DOIUrl":"10.1159/000547689","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenic obesity (SO), characterized by the coexistence of reduced skeletal muscle mass and increased fat mass, impairs physical function and mental health. It is commonly associated with comorbidities such as atherosclerotic heart disease, diabetes mellitus, and hypertension. These conditions elevate the risk of osteoporosis and fractures, which may serve as early clinical indicators of SO. With global economic development and an aging population, the prevalence of SO is rising rapidly.</p><p><strong>Summary: </strong>This narrative review explores recent advances in the clinical diagnosis of SO, with a particular focus on the application of auxiliary imaging techniques in both qualitative and quantitative assessments. The review synthesizes findings from current clinical research and evaluates the role of imaging tools in improving diagnostic accuracy and treatment strategies for SO. Despite significant progress, challenges remain in terms of accessibility, cost-efficiency, and practical implementation of these technologies in routine clinical practice.</p><p><strong>Key messages: </strong>SO is a growing public health concern due to population aging and increasing comorbidities. Diagnostic imaging plays a vital role in enhancing the detection and management of SO. There is a pressing need to develop affordable and accessible diagnostic tools to meet clinical demands.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"1-13"},"PeriodicalIF":4.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-10-03DOI: 10.1159/000541782
Beatrice Leyaro, Daniel Boakye, Lyz Howie, Abdulmajid Ali, Raymond Carragher
Introduction: Bariatric surgery has been shown to provide significant patient benefits in terms of weight loss and mitigation of obesity-linked comorbidities, as well as providing improvements in occupational productivity and patient quality of life. However, the choice of which bariatric surgery procedure provides the most patient benefit in each of these cases is still in question. In this review, we provide a systematic review, with the objective of evaluating associations between different bariatric surgery procedures and mitigation of obesity-linked comorbidities, improvement in occupational productivity, and patient quality of life, concentrating on three areas: obstructive sleep apnoea (OSA), employment prospects, and body image.
Methods: The CINAHL, PubMed, Web of Science, and CENTRAL databases were searched for eligible studies. Summary risk ratio (RR) and 95% confidence intervals were estimated using random-effects models. Thirty-three studies were included in this review, including 29 cohort studies and 4 randomised clinical trials (RCTs).
Results: Pooled analysis of the observational studies showed significantly lower OSA remission in sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB) across both short-term (1-2 years) and longer term (3+ years) follow-up periods (RR = 0.91, 95% CI = 0.84-0.99, p = 0.02; and RR = 0.88, 95% CI = 0.65-0.99, p = 0.03, respectively). In contrast, a meta-analysis of the RCT studies found no difference in OSA remission between SG and RYGB (RR = 1.01, 95% CI = 0.81-1.25, p = 0.93). An analysis of four studies showed significantly higher OSA remission for SG versus adjustable gastric banding (RR = 1.83, 95% CI = 1.57-2.14, p < 0.001). No significant difference was observed regarding improvement in employment status between SG and RYGB (RR = 0.77, 95% CI = 0.32-1.87, p = 0.57). A narrative synthesis of studies on body image reported no significant differences between body image scores and surgery types.
Conclusion: This review found significantly lower OSA remission in SG as compared to RYGB across different follow-up periods, while no significant statistical difference was observed in RCT studies. Further studies are recommended to assess the effectiveness of the various bariatric surgeries in relation to improving employment status and body image, where primary studies are lacking.
简介减肥手术在减轻体重、缓解与肥胖相关的并发症、提高工作效率和患者生活质量方面为患者带来了显著的益处。然而，在每种情况下，选择哪种减肥手术能为患者带来最大益处仍是个问题。在本研究中，我们进行了一项系统性回顾，目的是评估不同减肥手术与减轻肥胖相关并发症、提高职业生产率和患者生活质量之间的关系，主要集中在三个方面：阻塞性睡眠呼吸暂停（OSA）、就业前景和身体形象：方法：在 CINAHL、PubMed、Web of Science 和 CENTRAL 数据库中搜索符合条件的研究。采用随机效应模型估算了总风险比（RR）和 95% 置信区间。本综述共纳入 33 项研究，包括 29 项队列研究和 4 项随机临床试验（RCT）：观察性研究的汇总分析显示，袖带胃切除术（SG）的 OSA 缓解率在短期（1-2 年）和长期（3 年以上）随访期间均显著低于 Roux-en-Y 胃旁路术（RYGB）（RR=0.91，95% CI = 0.84-0.99，p=0.02；RR=0.88，95% CI = 0.65-0.99，p=0.03）。与此相反，RCT 研究的荟萃分析发现，SG 和 RYGB 的 OSA 缓解率没有差异（RR=1.01，95% CI = 0.81-1.25，p=0.93）。对四项研究的分析表明，SG 的 OSA 缓解率明显高于可调节胃束带（RR=1.83，95% CI = 1.57-2.14，p<0.001）。在就业状况的改善方面，SG 与 RYGB 之间无明显差异（RR=0.77，95% CI = 0.32-1.87，p = 0.57）。对身体形象研究的叙述性综合报告显示，身体形象评分与手术类型之间无明显差异：本综述发现，在不同的随访期内，SG 的 OSA 缓解率明显低于 RYGB，而在 RCT 研究中未观察到明显的统计学差异。建议进一步开展研究，以评估各种减肥手术在改善就业状况和身体形象方面的效果，因为目前还缺乏这方面的初步研究。
{"title":"Associations between Type of Bariatric Surgery and Obstructive Sleep Apnoea, Employment Outcomes, and Body Image Satisfaction: A Systematic Review and Meta-Analysis.","authors":"Beatrice Leyaro, Daniel Boakye, Lyz Howie, Abdulmajid Ali, Raymond Carragher","doi":"10.1159/000541782","DOIUrl":"10.1159/000541782","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery has been shown to provide significant patient benefits in terms of weight loss and mitigation of obesity-linked comorbidities, as well as providing improvements in occupational productivity and patient quality of life. However, the choice of which bariatric surgery procedure provides the most patient benefit in each of these cases is still in question. In this review, we provide a systematic review, with the objective of evaluating associations between different bariatric surgery procedures and mitigation of obesity-linked comorbidities, improvement in occupational productivity, and patient quality of life, concentrating on three areas: obstructive sleep apnoea (OSA), employment prospects, and body image.</p><p><strong>Methods: </strong>The CINAHL, PubMed, Web of Science, and CENTRAL databases were searched for eligible studies. Summary risk ratio (RR) and 95% confidence intervals were estimated using random-effects models. Thirty-three studies were included in this review, including 29 cohort studies and 4 randomised clinical trials (RCTs).</p><p><strong>Results: </strong>Pooled analysis of the observational studies showed significantly lower OSA remission in sleeve gastrectomy (SG) compared to Roux-en-Y gastric bypass (RYGB) across both short-term (1-2 years) and longer term (3+ years) follow-up periods (RR = 0.91, 95% CI = 0.84-0.99, p = 0.02; and RR = 0.88, 95% CI = 0.65-0.99, p = 0.03, respectively). In contrast, a meta-analysis of the RCT studies found no difference in OSA remission between SG and RYGB (RR = 1.01, 95% CI = 0.81-1.25, p = 0.93). An analysis of four studies showed significantly higher OSA remission for SG versus adjustable gastric banding (RR = 1.83, 95% CI = 1.57-2.14, p < 0.001). No significant difference was observed regarding improvement in employment status between SG and RYGB (RR = 0.77, 95% CI = 0.32-1.87, p = 0.57). A narrative synthesis of studies on body image reported no significant differences between body image scores and surgery types.</p><p><strong>Conclusion: </strong>This review found significantly lower OSA remission in SG as compared to RYGB across different follow-up periods, while no significant statistical difference was observed in RCT studies. Further studies are recommended to assess the effectiveness of the various bariatric surgeries in relation to improving employment status and body image, where primary studies are lacking.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"57-71"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142372441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-09-17DOI: 10.1159/000547937
In the article by Dobbie et al. entitled "Ten Top Tips for the Management of GLP-1 Receptor Agonists in Adults within Primary Care" [Obes Facts. 2025; https://doi.org/10.1159/000546472], there is an error introduced during production which has resulted in the PDF version of the article erroneously displaying the Open Access license type as "CC BY-NC" when the correct license type is in fact "CC-BY."
{"title":"Erratum.","authors":"","doi":"10.1159/000547937","DOIUrl":"10.1159/000547937","url":null,"abstract":"<p><p><body><sec id=\"s1\"><title /><p>In the article by Dobbie et al. entitled \"Ten Top Tips for the Management of GLP-1 Receptor Agonists in Adults within Primary Care\" [Obes Facts. 2025; <ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://doi.org/10.1159/000546472\">https://doi.org/10.1159/000546472</ext-link>], there is an error introduced during production which has resulted in the PDF version of the article erroneously displaying the Open Access license type as \"CC BY-NC\" when the correct license type is in fact \"CC-BY.\"</p><p>The original article has been updated.</p></sec></body>.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"675"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-05-02DOI: 10.1159/000546217
Albana Berisha, Albana Berisha, Wieland Kiess, Ruth Gausche, Christoph Beger, Antje Körner, Ulrike Spielau, Roland Pfäffle, Robert Stein, Anika Kaspar, Mandy Vogel
Introduction: Research on severe obesity (SO) is scarce and often contradictory. As higher weight status persists into adulthood, we aimed to analyze long-term trends in the prevalence of SO in children and adolescents in Germany using a large real-world data set. Furthermore, we analyzed subgroup differences and assessed how the COVID-19 pandemic affected weight status.
Methods: We analyzed data from the CrescNet auxological network, including 1,495,401 clinical visits by 4- to 16-year-old children (2002-2023). Weight trends were examined with a focus on SO using logistic regression, stratified by sex and age. Effects are reported as odds ratio per 5 years (OR5) pre-pandemic and as OR for consecutive years during the pandemic. Quantile regression assessed trends of the 50th, 90th, 97th, and 99th percentiles of excess weight.
Results: Pre-pandemic, SO remained stable or declined in children under 12 until 2010: OR5: 0.8-1, p < 0.001) but rose significantly afterward (OR5: 1.1-1.2, p < 0.001). Children between 12 and 16 years of age showed a continuous increase, especially boys (boys12-16: OR5: 1.3, girls12-16: OR5: 1.1, p < 0.001). During the pandemic, SO peaked in 2021 across all groups (OR21 vs. 19: 1.3-1.7, p < 0.001). By 2023, younger children had returned to pre-pandemic levels, while older children, particularly 8- to 16-year-old girls, remained at higher weights (OR23 vs. 19: 1.2-1.5, p < 0.001-0.002). Weight gain was most prominent in SO groups but could also be seen in pre-pandemic and pandemic overweight and obesity subgroups, generally decreasing toward the end of the pandemic.
Conclusion: SO has increased over the last 2 decades, with the COVID-19 pandemic accelerating this trend, particularly in adolescents. While younger children recovered by 2023, excess weight in older children, especially girls, continues to escalate.
.
关于重度肥胖（SO）的研究很少，而且经常是矛盾的。由于高体重状态持续到成年，我们的目的是使用大量真实数据集分析德国儿童和青少年中SO患病率的长期趋势。此外，我们分析了亚组差异，并评估了COVID-19大流行如何影响体重状况。方法我们分析来自CrescNet生理网络的数据，包括2002-2023年间4-16岁儿童的1,495,401次临床就诊。使用逻辑回归，按性别和年龄分层，重点研究体重趋势。以大流行前每5年的优势比（OR5）和大流行期间连续数年的优势比报告效果。分位数回归评估了超重的第50、90、97和99个百分位数的趋势。结果大流行前，12岁以下儿童的SO保持稳定或下降，直到2010年：OR5: 0.8-1, p
{"title":"From Childhood to Adolescence: Long-Term Trends in Severe Obesity in German Youth (2002-2023).","authors":"Albana Berisha, Albana Berisha, Wieland Kiess, Ruth Gausche, Christoph Beger, Antje Körner, Ulrike Spielau, Roland Pfäffle, Robert Stein, Anika Kaspar, Mandy Vogel","doi":"10.1159/000546217","DOIUrl":"10.1159/000546217","url":null,"abstract":"<p><p><p>Introduction: Research on severe obesity (SO) is scarce and often contradictory. As higher weight status persists into adulthood, we aimed to analyze long-term trends in the prevalence of SO in children and adolescents in Germany using a large real-world data set. Furthermore, we analyzed subgroup differences and assessed how the COVID-19 pandemic affected weight status.</p><p><strong>Methods: </strong>We analyzed data from the CrescNet auxological network, including 1,495,401 clinical visits by 4- to 16-year-old children (2002-2023). Weight trends were examined with a focus on SO using logistic regression, stratified by sex and age. Effects are reported as odds ratio per 5 years (OR<sub>5</sub>) pre-pandemic and as OR for consecutive years during the pandemic. Quantile regression assessed trends of the 50th, 90th, 97th, and 99th percentiles of excess weight.</p><p><strong>Results: </strong>Pre-pandemic, SO remained stable or declined in children under 12 until 2010: OR<sub>5</sub>: 0.8-1, p < 0.001) but rose significantly afterward (OR<sub>5</sub>: 1.1-1.2, p < 0.001). Children between 12 and 16 years of age showed a continuous increase, especially boys (boys<sub>12-16</sub>: OR<sub>5</sub>: 1.3, girls<sub>12-16</sub>: OR<sub>5</sub>: 1.1, p < 0.001). During the pandemic, SO peaked in 2021 across all groups (OR<sub>21 vs. 19</sub>: 1.3-1.7, p < 0.001). By 2023, younger children had returned to pre-pandemic levels, while older children, particularly 8- to 16-year-old girls, remained at higher weights (OR<sub>23 vs. 19</sub>: 1.2-1.5, p < 0.001-0.002). Weight gain was most prominent in SO groups but could also be seen in pre-pandemic and pandemic overweight and obesity subgroups, generally decreasing toward the end of the pandemic.</p><p><strong>Conclusion: </strong>SO has increased over the last 2 decades, with the COVID-19 pandemic accelerating this trend, particularly in adolescents. While younger children recovered by 2023, excess weight in older children, especially girls, continues to escalate. </p>.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"503-513"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-06-21DOI: 10.1159/000546218
Anette Schnieber, Pernille Andreassen, Tina Vilsbøll, Per Nielsen, Cecilie Yssing, Amanda Falah Rasmussen, Signe Stensen, Kasper Nørremark, Jens Meldgaard Bruun
Introduction: When discussing body weight with health care professionals (HCPs), people living with obesity (PwO) can feel stigmatised by specific terms. In English-speaking research settings, PwO have expressed preferences for "technical" or health-related terms (e.g., weight; body mass index [BMI]), as opposed to vernacular terms (e.g., fatness), but no such studies have been conducted in a Danish linguistic and cultural setting. The aim of the present study was to investigate preferences of PwO for weight-related terminology in conversations with HCPs in a Danish context.
Methods: The study utilised survey data from the Awareness, Care, and Treatment In Obesity maNagement-Denmark (ACTION-DK) study among Danish adults with a self-reported BMI ≥30.0 kg/m2.
Results: A total of 879 Danish adults with obesity completed the questionnaire on preferred weight-related terminology, preferred HCP communication actions in weight loss conversation, and acceptability of HCPs raising the topic of weight. Respondents preferred technical or health related, person-first terminology; weight, overweight, high BMI, and higher weight were most preferred; fat, extra large, chubby, morbid obesity, and curvy were least preferred. A total of 71% respondents appreciated their HCP raising the topic of weight. When prioritising HCP communication actions in weight-loss conversations, PwO emphasised empathy and respectfulness over concrete actions.
Conclusion: The present study is the first to investigate PwO preference for weight-related terminology in a Danish setting, with findings overall in support of similar international studies. The identification of specific, acceptable terms, together with the proportion of respondents appreciating their HCP raising the topic of weight, indicate that respectful conversations between PwO and HCPs about weight are possible. However, HCPs should always enquire about an individual's preferences.
{"title":"Preferences for Body Weight-Related Terminology for People Living with Obesity: Results from the ACTION-DK Study.","authors":"Anette Schnieber, Pernille Andreassen, Tina Vilsbøll, Per Nielsen, Cecilie Yssing, Amanda Falah Rasmussen, Signe Stensen, Kasper Nørremark, Jens Meldgaard Bruun","doi":"10.1159/000546218","DOIUrl":"10.1159/000546218","url":null,"abstract":"<p><p><p>Introduction: When discussing body weight with health care professionals (HCPs), people living with obesity (PwO) can feel stigmatised by specific terms. In English-speaking research settings, PwO have expressed preferences for \"technical\" or health-related terms (e.g., weight; body mass index [BMI]), as opposed to vernacular terms (e.g., fatness), but no such studies have been conducted in a Danish linguistic and cultural setting. The aim of the present study was to investigate preferences of PwO for weight-related terminology in conversations with HCPs in a Danish context.</p><p><strong>Methods: </strong>The study utilised survey data from the Awareness, Care, and Treatment In Obesity maNagement-Denmark (ACTION-DK) study among Danish adults with a self-reported BMI ≥30.0 kg/m2.</p><p><strong>Results: </strong>A total of 879 Danish adults with obesity completed the questionnaire on preferred weight-related terminology, preferred HCP communication actions in weight loss conversation, and acceptability of HCPs raising the topic of weight. Respondents preferred technical or health related, person-first terminology; weight, overweight, high BMI, and higher weight were most preferred; fat, extra large, chubby, morbid obesity, and curvy were least preferred. A total of 71% respondents appreciated their HCP raising the topic of weight. When prioritising HCP communication actions in weight-loss conversations, PwO emphasised empathy and respectfulness over concrete actions.</p><p><strong>Conclusion: </strong>The present study is the first to investigate PwO preference for weight-related terminology in a Danish setting, with findings overall in support of similar international studies. The identification of specific, acceptable terms, together with the proportion of respondents appreciating their HCP raising the topic of weight, indicate that respectful conversations between PwO and HCPs about weight are possible. However, HCPs should always enquire about an individual's preferences. </p>.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"592-606"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-06-25DOI: 10.1159/000546795
Jane Jia Xin Lim, Amanda J Hooper, Joan Khoo, Wann Jia Loh
Introduction: Pathogenic heterozygous melanocortin-4 receptor (MC4R) variants are the most common cause of monogenic obesity, affecting central satiety and appetite regulatory areas of the brain. Case Presentations: We report a pedigree with a pathogenic MC4R variant (c.380C>T, p.Ser127Leu). In the proband with obesity (BMI 35 kg/m2) and severe insulin resistance, use of combination of semaglutide and naltrexone-bupropion was successful in reducing insulin requirements and weight. His adult monozygotic twin daughters both had childhood-onset obesity; however, weight trajectories differed. Twin 1 had a peak BMI of 29.1 kg/m2, which decreased to 19.7 kg/m2 with intensive exercise and diet control without weight-lowering medication. Twin 2 had a sedentary lifestyle and epilepsy and had a peak BMI of 30.1 kg/m2; she responded well to naltrexone-bupropion and BMI decreased to 26 kg/m2. Conclusion: The manifestation of obesity, even in cases of monogenic obesity, can vary significantly due to the influence of environmental and lifestyle factors.
{"title":"Diverse Obesity Trajectories in a Family Including Identical Twins with a Pathogenic <italic>MC4R</italic> Variant.","authors":"Jane Jia Xin Lim, Amanda J Hooper, Joan Khoo, Wann Jia Loh","doi":"10.1159/000546795","DOIUrl":"10.1159/000546795","url":null,"abstract":"<p><p><p>Introduction: Pathogenic heterozygous melanocortin-4 receptor (MC4R) variants are the most common cause of monogenic obesity, affecting central satiety and appetite regulatory areas of the brain. Case Presentations: We report a pedigree with a pathogenic MC4R variant (c.380C>T, p.Ser127Leu). In the proband with obesity (BMI 35 kg/m2) and severe insulin resistance, use of combination of semaglutide and naltrexone-bupropion was successful in reducing insulin requirements and weight. His adult monozygotic twin daughters both had childhood-onset obesity; however, weight trajectories differed. Twin 1 had a peak BMI of 29.1 kg/m2, which decreased to 19.7 kg/m2 with intensive exercise and diet control without weight-lowering medication. Twin 2 had a sedentary lifestyle and epilepsy and had a peak BMI of 30.1 kg/m2; she responded well to naltrexone-bupropion and BMI decreased to 26 kg/m2. Conclusion: The manifestation of obesity, even in cases of monogenic obesity, can vary significantly due to the influence of environmental and lifestyle factors. </p>.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"646-655"},"PeriodicalIF":4.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2024-10-30DOI: 10.1159/000542155
Giovanna Muscogiuri, Luigi Barrea, Silvia Bettini, Marwan El Ghoch, Niki Katsiki, Liisa Tolvanen, Ludovica Verde, Annamaria Colao, Luca Busetto, Volkan Demirhan Yumuk, Maria Hassapidou
Obesity, a prevalent and multifactorial disease, is linked to a range of metabolic abnormalities, including insulin resistance, dyslipidemia, and chronic inflammation. These imbalances not only contribute to cardiometabolic diseases but also play a significant role in cancer pathogenesis. The rising prevalence of obesity underscores the need to investigate dietary strategies for effective weight management for individuals with overweight or obesity and cancer. This European Society for the Study of Obesity (EASO) position statement aimed to summarize current evidence on the role of obesity in cancer and to provide insights on the major nutritional interventions, including the Mediterranean diet (MedDiet), the ketogenic diet (KD), and the intermittent fasting (IF), that should be adopted to manage individuals with overweight or obesity and cancer. The MedDiet, characterized by high consumption of plant-based foods and moderate intake of olive oil, fish, and nuts, has been associated with a reduced cancer risk. The KD and the IF are emerging dietary interventions with potential benefits for weight loss and metabolic health. KD, by inducing ketosis, and IF, through periodic fasting cycles, may offer anticancer effects by modifying tumor metabolism and improving insulin sensitivity. Despite the promising results, current evidence on these dietary approaches in cancer management in individuals with overweight or obesity is limited and inconsistent, with challenges including variability in adherence and the need for personalized dietary plans.
背景：肥胖症是一种普遍存在的多因素疾病，与一系列代谢异常有关，包括胰岛素抵抗、血脂异常和慢性炎症。这些失衡不仅会导致心脏代谢疾病，而且在癌症发病机制中也起着重要作用。肥胖症发病率的上升凸显了研究饮食策略的必要性，以便对超重或肥胖症患者和癌症患者进行有效的体重管理。这份欧洲肥胖症研究学会（EASO）的立场声明旨在总结肥胖症在癌症中的作用的现有证据，并就主要的营养干预措施提供见解，包括地中海饮食（MedDiet）、生酮饮食（KD）和间歇性禁食（IF），这些都是管理超重或肥胖与癌症患者应采取的措施：结果：地中海饮食的特点是多吃植物性食物，适量摄入橄榄油、鱼和坚果，这与降低癌症风险有关。KD 和 IF 是新兴的饮食干预措施，对减肥和新陈代谢健康具有潜在的益处。KD通过诱导酮病，IF通过周期性禁食，可通过改变肿瘤代谢和改善胰岛素敏感性来达到抗癌效果：尽管取得了令人鼓舞的成果，但目前有关这些饮食方法在超重或肥胖患者癌症管理方面的证据有限且不一致，面临的挑战包括坚持治疗的不确定性和个性化饮食计划的必要性。
{"title":"European Association for the Study of Obesity (EASO) Position Statement on Medical Nutrition Therapy for the Management of Individuals with Overweight or Obesity and Cancer.","authors":"Giovanna Muscogiuri, Luigi Barrea, Silvia Bettini, Marwan El Ghoch, Niki Katsiki, Liisa Tolvanen, Ludovica Verde, Annamaria Colao, Luca Busetto, Volkan Demirhan Yumuk, Maria Hassapidou","doi":"10.1159/000542155","DOIUrl":"10.1159/000542155","url":null,"abstract":"<p><p>Obesity, a prevalent and multifactorial disease, is linked to a range of metabolic abnormalities, including insulin resistance, dyslipidemia, and chronic inflammation. These imbalances not only contribute to cardiometabolic diseases but also play a significant role in cancer pathogenesis. The rising prevalence of obesity underscores the need to investigate dietary strategies for effective weight management for individuals with overweight or obesity and cancer. This European Society for the Study of Obesity (EASO) position statement aimed to summarize current evidence on the role of obesity in cancer and to provide insights on the major nutritional interventions, including the Mediterranean diet (MedDiet), the ketogenic diet (KD), and the intermittent fasting (IF), that should be adopted to manage individuals with overweight or obesity and cancer. The MedDiet, characterized by high consumption of plant-based foods and moderate intake of olive oil, fish, and nuts, has been associated with a reduced cancer risk. The KD and the IF are emerging dietary interventions with potential benefits for weight loss and metabolic health. KD, by inducing ketosis, and IF, through periodic fasting cycles, may offer anticancer effects by modifying tumor metabolism and improving insulin sensitivity. Despite the promising results, current evidence on these dietary approaches in cancer management in individuals with overweight or obesity is limited and inconsistent, with challenges including variability in adherence and the need for personalized dietary plans.</p>","PeriodicalId":19414,"journal":{"name":"Obesity Facts","volume":" ","pages":"86-105"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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