Obesity Reviews最新文献

Background: Colorectal cancer (CRC) has recently been identified as the world's third commonest cause of cancer death, accounting for 900,000 deaths per year. Obesity-related CRC has also been on the rise, with research indicating that increasing body mass index (BMI) is associated with an increased risk of CRC. As a result, there is a need to find safe and effective treatment options for CRC, and one potential complementary therapy might be Chinese medicine (CM), which has gained popularity in recent years.

Scope and approach: This review focuses on the role of CM as a complementary therapy in obesity-associated CRC. The pathophysiological mechanisms of obesity-associated CRC are first reviewed, followed by an overview of several CM methods for managing obesity-associated CRC. Following that, we will discuss current research on the prospects of integrating CM with conventional oncology and conclude with some suggestions for future research.

Key findings and discussion: Complementary CM approaches may be beneficial in the management of obesity-related CRC. The diverse range of pharmacological and nonpharmacological treatments offers several pathways for safe and effective treatment and has the potential to be used in the management of obesity-related CRC and its comorbidities. In addition, combining CM with conventional oncological methods could benefit patients and improve their quality of life during and/or after treatment. Therefore, we hope that these findings may be applied to the long-term therapy of obesity-related CRC and other cancers.

Adipose tissue, beyond its role as a fat storage depot, functions as an endocrine organ, secreting signaling molecules systemically and via paracrine mechanisms (particularly in perivascular and ectopic fat). These diverse functions are crucial for regulating metabolic and cardiovascular health. The circadian clock, an internal ~24-h biological rhythm, orchestrates physiological processes to adapt to environmental cycles (e.g., light, temperature, food). This involves linking gene transcription/translation events to the external environment. Recent studies demonstrate circadian expression patterns in adipose tissue for various genes and metabolic pathways. Disrupted circadian rhythms are implicated in adipose tissue and metabolic dysfunction. Understanding adipose tissue circadian mechanisms may provide strategies to mitigate metabolic and associated cardiovascular disease risk. This review summarizes recent findings on the relationship between circadian rhythms and adipose tissue metabolism, explores how an adipose clock contributes to the pathogenesis of metabolic diseases, and discusses potential therapeutic approaches targeting the adipose tissue clock.

Background: Obesity is a well-documented cardiovascular risk factor. Here, we sought to investigate whether obesity causes subclinical cardiac remodeling and heart failure (HF), and if so, to perform a systematic scan of the plasma protein for novel drug targets.

Methods: We leveraged visceral adipose tissue (VAT), waist circumference (WC), and waist-to-hip ratio (WHR)-all adjusted for body mass index (BMI)-as indicators of obesity. Two-sample Mendelian randomization (MR) analyses were used to estimate the independent, causal effects of obesity on cardiovascular magnetic resonance (CMR)-derived cardiac traits and HF risk. Mediation analyses followed by druggability assessment were conducted to identify promising protein targets for therapeutic translation.

Results: Genetically determined VATadjBMI, WCadjBMI, and WHRadjBMI presented broad causal associations with alterations of distinct cardiac phenotypes, most of which remained significant after controlling for obesity-induced cardiometabolic risk factors, including hypertension, type 2 diabetes, and adverse lipid profiles. By contrast, WHRadjBMI is the only independent causal predictor for HF risk. Of 142 proteins with mediating effects, scavenger receptor class A member 5 (SCARA5), membrane cofactor protein (CD46), and alpha-1-antichymotrypsin (SERPINA3) may contribute to the early-stage adverse cardiovascular effect of obesity, whereas apolipoprotein C-III (APOC3), mitochondrial aldehyde dehydrogenase 2 (ALDH2), and chordin-like protein 2 (CHRDL2) may further promote the development of obesity-driven HF. Medications targeted at these candidate proteins are either approved or under evaluation in clinical trials.

Conclusions: Our MR findings provided genetic evidence for the direct, causal associations of obesity with cardiac remodeling and HF, while also outlining druggable proteins as promising therapeutic targets.

Emotions represent potential triggers for binge eating, and binge eating can serve as a dysfunctional emotion regulation strategy. Therefore, we investigated emotion-related treatments in patients with binge eating in a systematic review. Change in binge eating were the primary outcome; eating disorder pathology and emotion-related outcomes were secondary outcomes. A meta-analysis was computed regarding pre-changes and post-changes in binge eating frequency within groups, and potential influencing factors were investigated, namely, BMI, eating disorder diagnosis, treatment type, aspects of BE outcome, age, and sex. Thirty-eight articles were included and 31 within the meta-analysis. Data quality was rated as moderate. The sample size varied strongly with a high proportion of women. Only five studies examined adolescents. Binge eating disorder (n = 18) and dialectical behavioral treatment (n = 16) were most frequently examined. Results show significant reductions in binge eating after treatment. Additionally, the systematic review indicates the superiority of emotion-related treatments compared with waitlist control groups and comparability with active control groups in terms of improvements in binge eating, eating disorder pathology, and emotion regulation. The effects appear to be stable at follow-up analyses from 1 to 12 months. Potential influencing factors did not affect the efficacy of emotion-related treatments. Overall, though meta-analytic results have to be interpreted with caution, emotion-related treatments hold promise in treating binge eating, and emotion regulation might represent a potential mechanism of change.

Obesity is intricately associated with the gut microbiome, and emerging research suggests that lifestyle interventions, such as dietary changes and active lifestyle, can significantly affect the composition and function of the gut microbiome. However, evidence demonstrating a causal link between these changes and long-term weight loss or metabolic improvements remains limited. This systematic review investigates how overweight- and obesity-targeted interventions, such as dietary modifications, physical activity, supplementation with prebiotics and probiotics, and fecal microbiota transplantation (FMT), manipulate gut microbiome diversity and composition, major metabolites, and weight status. We conducted a systematic literature search and included 87 out of 255 randomized clinical trials with 6086 adults aged 18-84 with a BMI ≥ 25 kg/m². The quality of the included RCTs ranged from very low to moderate risk of bias. Most interventions did not cause any significant changes in microbial alpha or beta diversity, however, positive associations between prebiotic consumption and abundance of Actinobacteria and Bifidobacterium were observed, and intake of probiotics was related to increased levels of Lactobacillus and reduced body weight and body fat. We did not observe strong evidence for associations between SCFA levels, gut microbiome, and obesity. Overall, diversity and heterogeneity in reported outcomes, both in methods and results, were large. Taken together, our findings suggest that overweight- and obesity-targeted dietary interventions of at least 4 weeks, particularly those involving prebiotics and probiotics, have the potential to beneficially alter the gut microbiome, although standardized protocols and harmonized reporting are needed to confirm this through meta-analysis.

Introduction: Individuals living with obesity often experience body image (BI) disturbances, which can negatively affect their quality of life and treatment outcomes. Virtual reality (VR) has emerged as a promising tool for enhancing psychological interventions, but no comprehensive review has specifically focused on VR-based studies addressing BI disturbances in this population.

Methods: This comprehensive review examined studies utilizing VR for the assessment and treatment of BI disturbances in individuals with obesity. Twelve studies met the inclusion criteria.

Results: Studies were categorized into three groups: (i) VR in psychological interventions for individuals with obesity, (ii) VR interventions following metabolic and bariatric surgery, and (iii) VR-based full-body illusion experiments. The primary clinical application was experiential cognitive therapy, which demonstrated greater efficacy in reducing negative BI compared with standard cognitive behavioral therapy and other treatments. Studies involving post-metabolic and bariatric surgery adults also supported VR's efficacy in reducing BI dissatisfaction, though long-term benefits were inconsistent. Full-body illusion experiments suggested that VR can help modify distorted body perceptions. However, most studies were conducted by the same research group, focused exclusively on women, and were limited to specific geographical regions, primarily Italy.

Conclusion: While preliminary results suggest that VR is a promising tool for treating BI disturbances in individuals with obesity, the field remains under-researched. Notably, no studies have explored VR's potential as an assessment tool in this population. Future studies should include more diverse populations, investigate long-term outcomes, and explore potential barriers to clinical implementation.

Inflammatory bowel disease is a chronic inflammatory disorder affecting the gastrointestinal tract. It mainly comprises of Crohn's disease and ulcerative colitis. Its global prevalence has risen simultaneously with overweight and obesity among children and young people over the last decades. This critical narrative review aims to explore how living with overweight or obesity contributes to the development of inflammatory bowel disease (IBD) as well as the disease course in children and young people. Approximately, 24% of children and young people with the disease are living with overweight or obesity, with the majority being diagnosed with ulcerative colitis. Obesity appears to be associated with increased disease activity, adverse effects, with increased adiposity contributing to IBD pathogenesis though multiple mechanisms. Here, we offer a novel mechanistic pathway to how obesity impacts on IBD pathogenesis. Increased adiposity appears to contribute to its pathogenesis through increased proinflammatory cytokines and microbiota imbalance leading to inflammation and increased intestinal permeability. Additionally, adiposity appears to exacerbate micronutrient deficiencies associated with inflammatory bowel disease, including iron and vitamin D. Obesity is also shown to be associated with increased disease activity. Finally, we review possible weight management interventions available to children and young people living with obesity and overweight and IBD. In conclusion, living with overweight and obesity are proposed to have adverse effects on inflammatory bowel disease in children and young people, with an urgent need for greater research to better understand their impacts and assist in guiding effective tailored interventions.

Mobile health interventions are promising behavior change tools, but they might benefit deprived populations less due to disparities in intervention uptake, engagement, and effectiveness. Evidence so far mainly stems from clinical trials, which may suffer from selection bias. This systematic review investigated differences in uptake of, engagement with, and effectiveness of exclusively mobile interventions for diet, physical activity, and sedentary behavior in adults and real-life contexts. Five databases (CINAHL, EMBASE, PsycINFO, PubMed, and Web of Science) were searched from inception to November 2023. Records were independently screened by two authors. Observational studies including adults were considered if they reported on uptake, engagement, or effectiveness of an exclusively mobile intervention and examined outcomes by at least one inequality indicator included in the PROGRESS-Plus framework. Of the 9707 identified records, 87 publications reporting on 88 studies were included. Most studies reported on intervention uptake and examined multiple inequality indicators. Younger age and higher socioeconomic position were mostly associated with increased uptake, although these differences did not translate to engagement or effectiveness. Results for other inequality indicators were mixed, and some (e.g., migration and sexual orientation) were rarely studied. Evidence regarding social inequality remains mixed, although some barriers to uptake, such as access to the required technology and digital literacy, exist. Research urgently needs to address potential inequalities beyond age, gender/sex, and socioeconomic position to ensure that mobile interventions do not widen existing health inequalities.

Background: Time-restricted eating (TRE) limits food intake to a specific daily window and has gained popularity, showing modest benefits for cardiometabolic health. However, perspectives and experiences from adults and healthcare professionals about TRE remain underexplored but are vital for successful implementation in research and clinical practice.

Objective: To synthesize qualitative evidence on participants' and healthcare professionals' experiences and perceptions of TRE, with a gender-based analytical lens.

Methods: A systematic search was conducted on four databases from their inception until March 2025, searching for studies reporting qualitative analysis of the perceptions and experiences associated with TRE in adults and healthcare professionals. Methodological quality was appraised using the CASP checklist. Thematic synthesis was applied to extract overarching themes, with additional gender-based analysis. Confidence in the findings was assessed using the GRADE-CERQual approach.

Results: Thirteen articles including 225 participants (aged between 18 and 74 years), of which 22 were health professionals and dietitians were included. Three themes were found: motivation; barriers and facilitators, including three subthemes in each: biological, psychological and socio-cultural. Women's perspectives were commonly related to disappointment with previous diet and body dissatisfaction as motivators, food craving and emotional eating behaviors as barriers, and improvement of healthy eating habits and hunger control as facilitators. Otherwise, men were more motivated by managing appetite with shorter eating windows and found routine and day planning as key facilitators.

Conclusion: Perceptions and experiences of TRE are shaped by diverse motivators and challenges. Tailored, gender-sensitive approaches to support TRE integration in clinical practice are needed. PROSPERO Registry Number: CRD420250649633.

Obesity is understood as a condition driven by interactions between genetics and environmental factors. The role of CD36 in the regulation of lipid metabolism and ectopic fat accumulation emerges as a key area of interest. This review presents CD36 not only as a crucial facilitator of fatty acid uptake but also as a regulator of how and where excess lipids are stored. Ectopic fat accumulation-lipid deposition in non-adipose tissues such as the liver, muscle, and pancreas-is linked to obesity-related complications, including metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiovascular risk. Through CD36, tissues that normally play minor roles in lipid storage become overloaded, leading to metabolic dysfunction. We offer a fresh perspective on the adipose tissue expandability hypothesis, positioning CD36 as a regulator of adipose tissue's capacity to store lipids. Possibly, once adipose tissue reaches its expansion limit, CD36-mediated mechanisms drive the spillover of lipids into ectopic sites, exacerbating obesity complications. This insight offers a transformative view of CD36 as a player in the metabolic tipping point between healthy fat storage and pathogenic fat deposition. The connection between CD36 and extracellular vesicles (EVs) hints at a broader network of inter-tissue communication that could further amplify ectopic fat accumulation. Finally, we list evidence showing how CD36 genetics are related to the predisposition to develop and manage obesity. By understanding the role of CD36 in fat storage regulation, new personalized therapeutic strategies may emerge, targeting its pathways to prevent or reverse the metabolic damage caused by ectopic fat.