Obesity Reviews最新文献

Digital behavioral change interventions (DBCIs) for weight-related behaviors may be less effective in disadvantaged populations, potentially widening health inequalities despite increased access. Limited research has explored the psychosocial mechanisms that may contribute to this divide. Following JBI guidelines for conducting scoping reviews, we conducted an electronic search on Embase, PubMed, APA PsycInfo, Web of Science, and SCOPUS on March 8, 2023, including studies published since 1990. The mechanisms of action ontology was used for deductive coding of the mechanisms discussed. The protocol was registered on the Open Science Framework (https://osf.io/ctua5). After initial screening of 17,503 papers, 21 studies met inclusion criteria, including RCTs, pre-post studies, systematic reviews, qualitative studies, cross-sectional, pilot, and feasibility studies. A second screen of 7840 articles in June 2025 identified three further studies that met the inclusion criteria. Socioeconomic inequalities and ethnicity were the predominant focus. Environment, motivation, and social influences were frequently cited mechanisms. However, mechanisms are inconsistently conceptualized and measured, highlighting a gap in explanatory research on the digital health divide.

Introduction: Reducing childhood overweight and obesity prevalence is a global public health priority. This systematic review and meta-analysis evaluated the effectiveness of behavioral weight management interventions delivered or referred to by health care providers in primary care settings.

Methods: Randomized controlled trials (RCTs) of behavioral interventions published up to 05/01/2026, involving participants < 18 years with overweight or obesity, were identified through Cochrane, MEDLINE, PubMed, and PsychINFO. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Meta-analyses calculated pooled mean differences in zBMI and BMI using random effects models. The primary outcome was zBMI change at 12 months; secondary outcomes included zBMI changes at program end, last follow-up, and BMI at 12 months.

Results: Fifty-nine RCTs (n = 10,454) were included; 23 trials (n = 3241) contributed to the primary outcome. At 12 months, the pooled mean difference in zBMI was -0.08 (95% CI -0.13 to -0.03, p < 0.01), favoring intervention groups. At program end (n = 30), the mean difference was -0.15 (95% CI -0.22 to -0.08), and at last follow-up (n = 37), -0.08 (95% CI -0.15 to -0.02). BMI at 12 months showed a mean difference of -0.37 (95% CI -0.72 to -0.01). Interventions referred to community settings achieved greater zBMI reductions (-0.14 [95% CI -0.2 to -0.08]) than those delivered within primary care (0.04 [95% CI -0.10 to 0.18]).

Conclusions: Behavioral weight management interventions for children delivered or referred to by health care professionals in primary care led to modest reductions in zBMI. Referrals to community-based interventions (e.g., HENRY) may yield greater improvements.

Introduction: Increased risk of suicidality has been reported in association with glucagon-like peptide receptor agonist (GLP-1 RA) prescription. Herein, we conducted a comprehensive review evaluating reports of GLP-1 RA prescription and suicidality.

Methods: Relevant articles were retrieved from OVID (Medline, EMBASE, AMED, PsycINFO, JBI EBP Database), PubMed, and Web of Science from inception to May 20, 2024. Primary research examining the association between GLP-1 RAs (i.e., dulaglutide, exenatide, liraglutide, lixisenatide, semaglutide, tirzepatide) and suicidality were included for analysis.

Results: Our findings indicate liraglutide (reported odds ratio [ROR] = 3.26, 95% CI = 2.53, 4.22) and semaglutide (ROR = 1.73; 95% CI = 0.30, 0.80) are significantly associated with a greater odds ratio of reported suicidal ideation. Similarly, tirzepatide was associated with greater odds of reported suicidal ideation; however, this was nonsignificant (ROR = 1.49; 95% CI = -0.41, 1.21). Similarly, semaglutide (ROR = 8.81; 95% CI = 3.69, 21.04) and liraglutide (ROR = 3.74; 95% CI = 1.23, 11.38) are also associated with a greater odds ratio of reported suicidal depression. No significant association between other GLP-1 RAs and suicidality was observed.

Discussion: Reports of aspects of suicidality and exposure to select GLP-1 RAs exist; notwithstanding, no causality between GLP-1 RA exposure and suicidality is apparent.

Background: The efficacy of individual cognitive behavioral therapy (CBT) components for managing pediatric obesity remains unclear. This study systematically evaluated the impacts of CBT and its constituent techniques in this population.

Method: We searched PubMed, Embase, and Cochrane CENTRAL from inception to July 17, 2024, for randomized controlled trials comparing CBT techniques or usual care targeting obesity management in children and adolescents with overweight or obesity. Component network meta-analyses provided estimates of effects of each component on obesity-related outcomes. We rated the certainty of evidence using modified GRADE approaches.

Results: We included 125 trials with 16,513 children and adolescents. For conceptual level components, compared with minimal education, behavioral therapy probably reduces body fat percentage (MD, -1.16%; 95% CI, -1.68% to -0.64%), waist circumference (MD, -1.70 cm; 95% CI, -2.74 to -0.67 cm), and improves quality of life (SMD, 0.16; 95% CI, 0.03-0.30). For technical-level components, when compared with minimal education, parental involvement (MD, -0.09; 95% CI, -0.16 to -0.03) and stimulus control (MD, -0.07; 95% CI, -0.12 to -0.01) probably reduce body mass index (BMI) z-score. Preplanning (MD, -3.05%; 95% CI, -5.82% to -0.28%) and feedback (MD, -2.73%; 95% CI, -5.31% to -0.14%) probably reduce body fat percentage, whereas device monitoring, problem-solving, rule-setting, and relaxation training might increase body fat percentage.

Interpretation: Behavioral therapy alone is likely effective for pediatric obesity management, irrespective of cognitive therapy integration. Techniques such as parental involvement, stimulus control, preplanning, and feedback should be prioritized in CBT.

Background and objectives: Childhood obesity is a global public health issue with strong familial and intergenerational transmission. However, existing syntheses often overlook the active role of parents and fail to assess outcomes beyond the child. This systematic review and meta-analysis specifically investigate the effects of family-based interventions, which position parents as active co-agents of change, on health outcomes for both children with obesity and their parents.

Methods: A systematic review and meta-analysis were conducted. Six databases were searched for randomized controlled trials (RCTs) targeting children with obesity and at least one family member. Primary outcomes were children's BMI z-score and parental BMI; secondary outcomes included other adiposity measures and dietary behaviors. Outcomes for both children and parents were synthesized. Subgroup analyses were conducted based on intervention characteristics. Risk of bias was assessed using RoB 2, and evidence certainty was evaluated using GRADE.

Results: Twenty RCTs with 1740 participants were included in the meta-analysis. The interventions demonstrated a significant reduction in children's BMI z-score. Additional benefits were observed for long-term BMI z-score and percentage of total body fat. The most effective interventions commonly integrate health education, behavioral strategies, and motivational support. Subgroup analyses indicated that interventions positioning parents as active co-participants, rather than mere supporters, yielded larger effects. However, no significant effects were found on parental BMI.

Conclusion: This study demonstrates that family-based interventions can confer significant benefits for children with obesity. Their success hinges on strategically framing parents as active co-agents and integrating motivational strategies.

Objective: This systematic review and meta-analysis aimed to identify common life-course body mass index (BMI) trajectories (childhood/adulthood to adulthood) and their impact on risk of cancer overall and cancer at different sites in adulthood.

Methods: Observational studies were identified that assessed the association of BMI trajectories with cancer risks from databases published in English. The pooled effect sizes were estimated using a random-effects model.

Findings: A total of 24 eligible studies were included in the meta-analysis. Transitioning from normal weight to obesity was significantly associated with an increased risk of colorectal cancer (effect size [ES] = 1.170, 95% CI: 1.096, 1.245), pancreatic cancer (ES = 1.337, 95% CI: 1.247, 1.426), kidney cancer (ES = 2.122, 95% CI: 1.619, 2.624), and liver cancer (ES = 1.777, 95% CI: 1.261, 2.293), compared to those in the stable normal weight trajectory. No significant difference in the risk of breast or prostate cancer was observed when comparing various BMI trajectories to a stable normal BMI trajectory.

Conclusion: The findings suggest that lifetime BMI trajectories influence cancer risk, with a transition from normal BMI to higher levels associated with an increased risk of cancer. The impact varied by trajectory and cancer type. Further studies are needed to confirm these findings.

Introduction: Weight loss results in reduced energy expenditure (EE) due to body composition alterations (e.g., fat-free mass and fat mass losses) and mass-independent adaptations in EE (e.g., hormones). Glucagon-like peptide-1 receptor agonists (GLP-1RA) are indicated for obesity management; however, their effects on EE remain unclear.

Methods: In this scoping review, we searched MEDLINE, EMBASE, CINAHL, Web of Science, ProQuest, and Cochrane Library (inception to October 2025) for studies that investigated the effects of GLP-1RA (mono or combination therapy) on EE in humans.

Results: Twenty-three studies were included, 10 assessed GLP-1RA monotherapy (4 exenatide, 4 liraglutide, 1 semaglutide, 1 beinaglutide) and 13 combination therapy (11 dual, 2 triple agonists); drug regimen heterogeneity was high. Most studies assessed resting metabolic rate (RMR); 4 used 24-h whole-room indirect calorimetry; and none applied doubly labeled water. Eight studies (34.8%) concluded that GLP-1RA mono or combination therapy had non-significant effects on EE. Combination with glucagon produced varied impacts on EE components (RQ [n = 3], RMR [n = 1], and sleep metabolic rate [n = 1]), whereas combination with glucose-dependent insulinotropic polypeptide (GIP) decreased RQ and increased fat utilization (n = 1). Eleven studies (47.8%) produced inconclusive results due to the applied statistical analyses.

Conclusion: Acute or chronic GLP-1RA monotherapy does not appear to impact EE independent of weight loss. Combining GLP-1RA with glucagon or GIP may impact EE in different ways, requiring further exploration.

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.

Adipose tissue thermogenesis, both uncoupling protein 1 (UCP1)-dependent and independent thermogenesis, plays a critical role in the homeostasis of whole-body metabolism. Emerging evidence demonstrates that key nodes in adipose tissue thermogenesis can be regulated by dynamic and reversible N⁶-methyladenosine (m⁶A) modification, which is one of the most prevalent and extensively studied RNA modifications. Furthermore, its dysregulation drives the pathogenesis of obesity and related metabolic disorders. In this review, we elucidate the role and molecular mechanisms of m⁶A modification in adipose tissue thermogenesis, highlight potential therapeutic strategies for promoting thermogenic remodeling of adipose tissue through targeting m⁶A modification, and discuss future research directions in this field. The insights provide clues for translational research aimed at developing m⁶A-based therapies for metabolic diseases.