Ranzenhofer LM, Shank LM, Thompson K
… +14 more, Schvey N, Wilfley DE, Young JF, Burke NL, Olsen CH, Lavender JM, Schrag R, Jorgensen S, Quinlan J, Klein DA, Haigney M, Yanovski JA, Sbrocco T, Tanofsky-Kraff M
OBJECTIVE: Given their unique psychosocial milieu, military-dependent youth (children of service members) may be vulnerable to excess weight gain, adverse cardiometabolic health, and binge eating. This study aimed to tes...OBJECTIVE: Given their unique psychosocial milieu, military-dependent youth (children of service members) may be vulnerable to excess weight gain, adverse cardiometabolic health, and binge eating. This study aimed to test the effects of group interpersonal psychotherapy (IPT), relative to a standard-of-care health education (HE) group, on these outcomes in adolescent military-dependents. METHODS: Military-dependent 12 to 17-year-olds with BMI ≥ 85th percentile and elevated anxiety and/or recent loss-of-control-eating participated in a multisite cluster randomized controlled trial comparing 12 weeks of adapted group IPT, targeting psychosocial problems, to a HE group. BMI, cardiometabolic health, and binge eating were assessed at baseline, posttreatment, and 1-year follow-up. BMI and cardiometabolic variables were measured or retrieved from electronic medical records at 2- and 3-year follow-ups. RESULTS: We were not able to recruit a fully powered trial; however, we analyzed data from 153 adolescent military-dependents (43.8% boys) with LOC-eating and/or high anxiety. There were no group differences between IPT and HE on outcomes. Some improvements in BMI indices, glucose regulation, and binge eating (p < 0.001) were observed across both groups. CONCLUSIONS: Group-based interventions may positively impact weight trajectories and cardiometabolic health among adolescent military-dependents. Future studies should elucidate potential moderators and mechanisms of interventions on outcomes in this important population. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT02671292.
Herrada-Robles M, Labayen I, Castro-Piñero J
… +8 more, Martínez-Vizcaíno V, Rojo-Tirado MA, Moliner-Urdiales D, Sanchís-Moysi J, Vidal-Conti J, Vicente-Rodriguez G, Tomkinson GR, Cadenas-Sanchez C
Obesity (Silver Spring)
· 2026 May · PMID 41793324
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OBJECTIVE: This study aimed to establish cut-points for cardiorespiratory fitness, muscular strength, and speed-agility and to evaluate their ability to detect general and central obesity risk in preschool children aged...OBJECTIVE: This study aimed to establish cut-points for cardiorespiratory fitness, muscular strength, and speed-agility and to evaluate their ability to detect general and central obesity risk in preschool children aged 3-5 years. METHODS: Briefly, 3179 Spanish preschoolers (52.8% boys) were evaluated. Physical fitness was assessed with the PREFIT battery. Anthropometry included BMI and waist circumference. Obesity risk was defined using age- and sex-specific percentiles according to criteria established by the World Health Organization and the International Diabetes Foundation. Receiver operating characteristic curve analyses were used to identify fitness cut-points. RESULTS: Age- and sex-specific cut-points were established. For cardiorespiratory fitness, cut-points ranged from 9.5 to 23.5 laps in boys and 6.5 to 21.5 in girls across the 3- to 5-year age range. Muscular strength cut-points ranged from z-scores of -1.5 to 2.2 in boys and -1.6 to 1.9 in girls. Speed-agility cut-points ranged from 18.8 to 14.9 s in boys and 19.9 to 15.3 s in girls. Predictive accuracy was moderate-to-high (AUC range: 0.61-0.74 for cardiorespiratory fitness, 0.59-0.80 for strength, 0.49-0.71 for speed-agility). CONCLUSIONS: This study provides fitness cut-points for detecting general and central obesity risk in preschoolers. Early integration of physical fitness assessments into health monitoring may facilitate early identification of obesity risk.
Lee HH, Avery CL, Graff M
… +5 more, Kim D, Arias J, Van Horn L, Kooperberg C, North KE
Obesity (Silver Spring)
· 2026 Apr · PMID 41792585
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OBJECTIVE: Long-term weight regain limits the population-level benefits of obesity interventions. We tested whether the polygenic risk score of BMI (PRS) modifies weight trajectories following modest weight loss. METHODS...OBJECTIVE: Long-term weight regain limits the population-level benefits of obesity interventions. We tested whether the polygenic risk score of BMI (PRS) modifies weight trajectories following modest weight loss. METHODS: The analytic sample included 9897 postmenopausal women from the Women's Health Initiative Dietary Modification Trial (6132 European American; 3749 African American). PRS was derived from a trans-ancestry GWAS of ~2 million participants. Longitudinal weight change (7 years) was modeled using weighted GEE. RESULTS: In European Americans, the PRS × randomization × time interactions approached significance at the 95th percentile (p = 0.052) and 85th percentile (p = 0.07). No interaction was observed in African Americans. In analyses restricted to European Americans who lost ≥ 5% of initial weight by year 1 (20%; n = 1273), women in the ≥ 95th percentile of PRS regained nearly twice as much per year as those with average risk (0.94 vs. 0.48 kg/year, p = 0.0016). CONCLUSIONS: A high PRS was associated with faster weight regain following modest weight loss in European American women. While further validation is required in a diverse population, these results suggest the potential for genetics to inform targeted strategies for sustaining long-term weight management. TRIAL REGISTRATION: ClinicalTrials.gov identifier: 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, and 75N92021D00005.
Alexander L, Purnell JQ, Burridge K
… +10 more, Cornier MA, Golden A, Horn DB, Look M, Nadglowski J, Ávila-Oliver C, Novillo F, Rojas-Gómez AM, Hussey B, Salas XR
Obesity (Silver Spring)
· 2026 Apr · PMID 41782434
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BACKGROUND: Obesity affects over 40% of US adults, with severe obesity on the rise. Despite recognition of obesity as a chronic disease, it remains underdiagnosed and undertreated. Access to evidence-based obesity treatm...BACKGROUND: Obesity affects over 40% of US adults, with severe obesity on the rise. Despite recognition of obesity as a chronic disease, it remains underdiagnosed and undertreated. Access to evidence-based obesity treatment is limited, leading to increased obesity severity and related complications. Barriers to obesity treatment include socioeconomic disparities, limited clinician training, stigma, and restrictive or absent reimbursement policies. FDA-approved obesity medications offer significant health benefits, prompting the need for updated, evidence-based guidance. METHODS: The Obesity Society (TOS), the Obesity Medicine Association (OMA), and the Obesity Action Coalition (OAC) convened a multidisciplinary panel, including patient representatives and obesity care providers, to develop a guidance statement using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Systematic evidence synthesis was conducted via Epistemonikos databases, with outcomes prioritized for clinical relevance, including weight reduction, quality of life, adverse events, and improvements in obesity complications. Recommendations were developed through consensus workshops and graded as strong or conditional based on evidence certainty, benefits, harms, equity, and feasibility using the GRADE Evidence-to-Decision framework. RESULTS: The panel issued recommendations on FDA-approved obesity medications including orlistat, bupropion-naltrexone, phentermine, phentermine-topiramate, liraglutide, semaglutide, tirzepatide, and setmelanotide. Strong recommendations were made for bupropion-naltrexone, semaglutide, tirzepatide, and setmelanotide, with moderate-certainty evidence. Conditional recommendations were made for other agents and specific obesity complications (obstructive sleep apnea, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatotic liver disease/metabolic dysfunction-associated steatohepatitis, osteoarthritis, major adverse cardiovascular events, and type 2 diabetes). Continuing obesity medications during weight maintenance received a strong recommendation. CONCLUSION: Obesity is a chronic, often progressive, disease requiring comprehensive, long-term, and person-centered care. Effective obesity medications exist but remain underutilized due to systemic barriers. Expanding access, reducing stigma, and ensuring equitable coverage are essential to translating scientific advances into population health gains. Future priorities include access and integration of comprehensive obesity care in the primary care setting, improving affordability, addressing research gaps, conducting head-to-head trials, and updating guidance as evidence evolves.
OBJECTIVE: Broadening usage of new antiobesity medications (AOMs, e.g., GLP-1 and GLP-1/GIP agonists) has prompted access concerns. We analyzed patient and appointment factors associated with AOM prescriptions, including...OBJECTIVE: Broadening usage of new antiobesity medications (AOMs, e.g., GLP-1 and GLP-1/GIP agonists) has prompted access concerns. We analyzed patient and appointment factors associated with AOM prescriptions, including changing AOM coverage in state Medicaid programs (MassHealth). METHODS: This was a retrospective pre-post study of medical weight management appointments at a large tertiary care center in January and April 2024, bracketing a MassHealth coverage change for AOMs. Patient and visit characteristics and AOMs prescribed were analyzed. RESULTS: A total of 2060 patients were analyzed. Multivariable analysis demonstrated that patients were more likely to receive Sema/Tirz compared to no or a different AOM with private insurance (aOR 2.744, p < 0.001), diabetes (aOR 2.507, p < 0.001), and established patient relationships (aOR 1.706, p < 0.001). In January 2024, Black and Hispanic patients were 49% and 47% less likely to be prescribed Sema/Tirz (p = 0.003, p = 0.025); in April 2024, after MassHealth changes, only patients of "Not Disclosed" race were less likely to receive these medications (p < 0.001). CONCLUSIONS: Black and Hispanic patients were less likely and patients with private insurance, diabetes, and established patient relationships were more likely to be prescribed Sema/Tirz. Racial and ethnic disparities in medication prescription were less apparent after a state Medicaid policy change to cover new GLP-1s.
Ruddiman KR, Hong YR, Ard J
… +5 more, Jones R, Medcalf A, Foster GD, Alkhaddo J, Cardel M
Obesity (Silver Spring)
· 2026 Jun · PMID 41766260
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OBJECTIVE: Antiobesity medications (AOMs) are indicated for long-term use; however, evidence of their real-world long-term efficacy is limited. This study describes clinical outcomes from 18- and 24-month use of AOMs in...OBJECTIVE: Antiobesity medications (AOMs) are indicated for long-term use; however, evidence of their real-world long-term efficacy is limited. This study describes clinical outcomes from 18- and 24-month use of AOMs in a telemedicine weight management clinic. METHODS: This retrospective observational study analyzed data from adult participants who utilized AOMs at a telemedicine weight management clinic between January 2022 and December 2024. Weight change analyses were conducted for those maintaining AOM use for ≥ 18 months (n = 11,675) and ≥ 24 months (n = 4317). Weight outcomes were assessed across all AOMs and stratified based on classification of AOMs utilized. RESULTS: Across all AOMs, average total body weight reduction of -18.53% (95% CI: -18.74%, -18.32%) was observed at 18 months and -20.27% (95% CI: -20.63%, -19.92%) seen at 24 months. For those taking long-acting AOMs, outcomes trended toward greater weight loss in comparison with participants using oral AOMs. CONCLUSIONS: This real-world analysis found 18- and 24-month weight losses comparable to those demonstrated in clinical trials, supporting the long-term efficacy of AOMs provided by a telemedicine weight management clinic. Continued weight loss was demonstrated between 18 and 24 months, suggesting sustained engagement with AOMs and a telemedicine weight management clinic support continued weight loss in the long term.
Adekunle OA, Le P, Boyer C
… +5 more, Gasoyan H, Gupta DY, Tran HT, Yue Y, Rothberg MB
Obesity (Silver Spring)
· 2026 Apr · PMID 41741949
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OBJECTIVE: This study aimed to evaluate the trends in antiobesity medication (AOM) and metabolic and bariatric surgery (MBS) use relative to the 2013 American Medical Association (AMA) declaration of obesity as a chronic...OBJECTIVE: This study aimed to evaluate the trends in antiobesity medication (AOM) and metabolic and bariatric surgery (MBS) use relative to the 2013 American Medical Association (AMA) declaration of obesity as a chronic disease and semaglutide approval in 2021 in the United States. METHODS: We employed a repeated cross-sectional design to analyze national electronic health records (EHR) of US adults (≥ 18 years) with obesity (BMI ≥ 30 kg/m) or overweight (BMI ≥ 27 kg/m) with ≥ 1 comorbidity for AOM and those with BMI ≥ 35 kg/m for MBS, using the All of Us dataset. We used interrupted time-series models to evaluate trends from January 1, 2003, to October 1, 2023. RESULTS: AOM rates increased by 0.31%/year (95% CI, 0.25%, 0.37%) after 2013 and further increased by 1.42%/year (95% CI, 1.16%, 1.68%) after 2021. MBS use declined by 0.10%/year (95% CI, -0.15%, -0.04%) before 2013. Semaglutide approval was not associated with MBS use decline after 2021. After 2013, patients with BMI ≥ 40 kg/m experienced a larger increase in AOM use (0.50% [95% CI, 0.40%, 0.61%]) vs. < 40 kg/m (0.25%/year [95% CI, 0.20%, 0.30%]) and stable MBS use. CONCLUSIONS: The declaration increased AOM use and, to a lesser extent, MBS use. Semaglutide approval increased AOM use but had no impact on MBS use.
Briand F, Le Cudennec C, Grasset E
… +4 more, Breyner N, Bigot C, Dillard P, Sulpice T
Obesity (Silver Spring)
· 2026 Jun · PMID 41741376
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OBJECTIVE/METHODS: Our aim was to evaluate the efficacy of the triple glucagon, GIP, and GLP-1 receptor agonist retatrutide in diet-induced obese MASH mouse and hamster models, two preclinical models that we routinely us...OBJECTIVE/METHODS: Our aim was to evaluate the efficacy of the triple glucagon, GIP, and GLP-1 receptor agonist retatrutide in diet-induced obese MASH mouse and hamster models, two preclinical models that we routinely use for assessing new therapies targeting obesity. RESULTS: In mice, retatrutide strongly reduced body weight by 31% (p < 0.0001 vs. vehicle), both fat and lean mass, and food and water intake during the first days of treatment, while energy expenditure was not altered significantly. Retatrutide markedly reduced the HOMA-IR index of insulin resistance, hepatic steatosis score, fatty acids, triglycerides, and total cholesterol content. In hamsters, retatrutide altered food preference with increased chow diet intake and decreased high fat/cholesterol diet and 10% fructose water intake. The significant weight loss was associated with a reduction in fat and lean mass, but the lean mass was not different after 5 weeks of treatment with no change in mineral bone density. Retatrutide significantly reduced HOMA-IR, plasma triglycerides, and LDL-cholesterol levels. Although retatrutide did not reduce histopathological scoring, there was a 50% reduction in hepatic triglyceride content (p < 0.01). CONCLUSIONS: Retatrutide demonstrates multiple metabolic benefits in both mouse and hamster models. Our preclinical setting will help to assess the efficacy of novel therapies targeting obesity and MASH.
Arnetorp I, Peltonen M, Sjöholm K
… +6 more, Svensson PA, Jacobson P, Taube M, Carlsson LMS, Andersson-Assarsson JC, Ahlin S
Obesity (Silver Spring)
· 2026 Apr · PMID 41738458
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OBJECTIVE: Bariatric surgery has been suggested to improve obstructive sleep apnea (OSA) in short-term studies, but long-term evidence is limited. We evaluated remission and new onset of OSA over 20 years in participants...OBJECTIVE: Bariatric surgery has been suggested to improve obstructive sleep apnea (OSA) in short-term studies, but long-term evidence is limited. We evaluated remission and new onset of OSA over 20 years in participants from the Swedish Obese Subjects (SOS) study, comparing bariatric surgery with usual obesity care. METHODS: The SOS study is a nonrandomized, controlled intervention study including 4047 individuals who received bariatric surgery (n = 2010) or usual obesity care (n = 2037). OSA status was assessed via questionnaires at baseline and at 1, 2, 3, 4, 6, 8, 10, 15, and 20 years. We examined remission and new onset of OSA among participants with or without the condition at baseline, comparing surgery to usual care. RESULTS: On average over 20 years, bariatric surgery was associated with a 32.1 percentage points lower prevalence of OSA in participants with baseline OSA (95% CI: -36.9 to -27.2; p < 0.001) compared to usual care. Among those without baseline OSA, surgery patients had a 5.8 percentage points lower prevalence of new-onset OSA (95% CI: -7.1 to -4.6; p < 0.001). CONCLUSIONS: Bariatric surgery was associated with durable OSA benefits, including higher remission and lower long-term new onset of OSA compared to usual obesity care. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01479452.
OBJECTIVE: This pilot study compared the effects of a calorie restricted diet (CRD) versus liraglutide on intrapancreatic fat deposition (IPFD) in people with obesity and explored associations between changes in adiposit...OBJECTIVE: This pilot study compared the effects of a calorie restricted diet (CRD) versus liraglutide on intrapancreatic fat deposition (IPFD) in people with obesity and explored associations between changes in adiposity-related metrics and glycemic-related parameters. METHODS: In this 24-week prospective nonrandomized study, participants with obesity received CRD or liraglutide. Primary endpoint was the change in pancreatic fat fraction (PFF). Secondary endpoints included changes in body weight, liver fat fraction (LFF), visceral fat area (VFA), and glycemic-related parameters. RESULTS: Both CRD (n = 23) and liraglutide (n = 23) demonstrated significant and comparable reductions in PFF (time effect: p < 0.001; interaction effect: p = 0.560). Significant and similar improvements were also observed in body weight, LFF, VFA, HbA1c, HOMA2-IR, and ISIM (all time effects: p < 0.001; all interaction effects: p > 0.05). Regression analysis indicated that ΔHOMA2-IR was positively associated with Δweight and ΔLFF but negatively with ΔPFF, while ΔISIM was negatively associated with ΔVFA and positively with ΔPFF. CONCLUSIONS: Both CRD and liraglutide significantly and similarly reduce pancreatic, liver, and visceral fat, while improving glycemic-related parameters in people with obesity. Preliminary findings suggest liver and visceral fat loss primarily drive improved insulin resistance, whereas pancreatic fat reduction may relate to subtler insulin dynamics changes, warranting further investigation. TRIAL REGISTRATION: This study is a sub-study of the registered trial ChiCTR1900022948.
OBJECTIVE: This study examined trends in clinical and preclinical obesity prevalence among US adults and their association with social determinants of health (SDOH) from 1999 to 2023. METHODS: We analyzed data from 60,50...OBJECTIVE: This study examined trends in clinical and preclinical obesity prevalence among US adults and their association with social determinants of health (SDOH) from 1999 to 2023. METHODS: We analyzed data from 60,506 adults aged ≥ 20 years in 11 cycles of the National Health and Nutrition Examination Survey (1999-2023). Clinical obesity was defined per the Lancet Diabetes & Endocrinology Commission on the definition and diagnosis of clinical obesity and preclinical obesity by excess adiposity without obesity-attributable complications. Eight SDOH domains were assessed individually and as a cumulative burden score. Age-standardized prevalence and associations were estimated using survey-weighted regression models. RESULTS: From 1999-2000 to 2021-2023, age-standardized prevalence of clinical obesity nearly doubled (14.3% to 26.6%; p < 0.001), driven by increases in class III obesity. Preclinical obesity increased modestly (17.1% to 20.6%; p = 0.038). Disparities widened significantly between those with highest (> 6) vs. lowest (< 3) cumulative SDOH burdens. In multivariable-adjusted analyses, unemployment (OR 1.50), food insecurity (OR 1.38), and high cumulative SDOH burden (OR 1.48) were strongly associated with clinical versus preclinical obesity, particularly class II-III severity. CONCLUSIONS: Clinical obesity increased dramatically, showing a strong dose-response relationship with social disadvantage and widening SDOH-based disparities, underscoring the need for targeted interventions addressing structural determinants among vulnerable populations.
Obesity (Silver Spring)
· 2026 Jun · PMID 41732031
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OBJECTIVE: This study aimed to evaluate whether reduced-frequency dosing of GLP1 receptor agonists maintains weight loss, body composition, and metabolic syndrome improvements following successful initial treatment with...OBJECTIVE: This study aimed to evaluate whether reduced-frequency dosing of GLP1 receptor agonists maintains weight loss, body composition, and metabolic syndrome improvements following successful initial treatment with standard weekly therapy. METHODS: This retrospective case series included 30 adults who achieved weight plateau while on weekly semaglutide or tirzepatide. Patients transitioned to reduced-frequency dosing (usually every other week) at their existing dose. Data were collected at three time points: pre-treatment, plateau (weekly dosing), and maintenance (reduced-frequency dosing). Primary outcome was change in body weight from plateau to maintenance. Secondary outcomes included body composition and metabolic syndrome comorbidities. RESULTS: Patients maintained reduced-frequency dosing for an average of 36.3 weeks. Weight decreased from 87.9 ± 2.4 kg at pre-treatment to 74.1 ± 2.4 kg at plateau and further to 72.4 ± 2.2 kg on maintenance dosing (p < 0.01). Total body and truncal fat declined, while skeletal muscle mass stabilized on the reduced-frequency regimen. Metabolic parameters improved during weekly dosing and these gains were maintained during reduced-frequency therapy. CONCLUSIONS: In patients with prior weight loss and metabolic improvement on GLP1 therapy, reduced-frequency maintenance dosing preserved outcomes. These findings support structured de-escalation as a promising strategy to reduce treatment burden without sacrificing efficacy.
Obesity (Silver Spring)
· 2026 Jun · PMID 41725218
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OBJECTIVE: This study compared population characteristics and overall US prevalence of obesity over time using the BMI criteria and the 2025 Lancet Commission criteria (i.e., the Excess Adiposity criteria). METHODS: We a...OBJECTIVE: This study compared population characteristics and overall US prevalence of obesity over time using the BMI criteria and the 2025 Lancet Commission criteria (i.e., the Excess Adiposity criteria). METHODS: We analyzed data from 58,053 adults aged ≥ 20 years in the National Health and Nutrition Examination Survey from 1999 to 2023. The Excess Adiposity criteria incorporated BMI, waist circumference, waist to hip and waist to height ratios, and body fat percentage to identify obesity, which was subclassified as preclinical or clinical based on organ dysfunction and activity limitations. Survey-weighted estimates were calculated to produce nationally representative trends. RESULTS: By BMI criteria, obesity prevalence increased from 31% (58.8 million) in 1999-2004 to 43% (101.3 million) in 2021-2023. By Excess Adiposity criteria, prevalence was higher and increasing from 51% (94.7 million) to 61% (143.9 million). The prevalence of clinical obesity is high due to a large number of people meeting criteria for organ dysfunction and/or activity limitations. CONCLUSIONS: Using the Excess Adiposity criteria to define obesity classifies nearly three in five US adults as having obesity, revealing substantial clinical, public health, and policy implications. The new criteria improve identification of individuals at risk but will require further strategies to achieve equitable, effective, and sustainable obesity prevention and treatment.
Mishra S, Su Y, Kumar A
… +8 more, Singh S, Finlin BS, Hsu FC, Lee J, Furdui CM, Kern PA, Das SK, Deep G
Obesity (Silver Spring)
· 2026 Apr · PMID 41725121
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OBJECTIVE: Glucose tolerance (GT) is a major effector for adipose tissue (AT) remodeling in obesity, yet its molecular mechanisms remain incompletely defined. We hypothesized that the biophysical and molecular profiles o...OBJECTIVE: Glucose tolerance (GT) is a major effector for adipose tissue (AT) remodeling in obesity, yet its molecular mechanisms remain incompletely defined. We hypothesized that the biophysical and molecular profiles of AT-derived small extracellular vesicles (sEV) change in response to glucose availability and differ by GT status. METHODS: sEV were isolated from plasma of individuals with normal GT (NGT) and impaired GT (IGT) (n = 5/group) at fasting (0 h) and 1 h post glucose challenge during oral glucose tolerance test (OGTT). sEV were characterized for size, concentration, surface expression of insulin receptor-α (INSRα), proteome, and insulin signaling-related miRNAs. C2C12 myotubes were treated with sEV for 48 h, followed by quantification of 84 insulin signaling-related genes. RESULT: The size and concentration of sEV did not differ between groups. At fasting, INSRα expression on sEV was comparable; however, groups exhibited opposite directional changes at 1-h OGTT. LC-MS/MS identified significant proteomic differences between NGT and IGT sEV. miR-27a-5p and miR-145a-5p levels in sEV also differed significantly by GT status. Notably, treatment with sEV (IGT-0 h) significantly downregulated insulin signaling-related genes in myotubes. CONCLUSIONS: Distinct molecular signatures in sEV offer a unique insight into AT dysfunction during IGT and offer novel diagnostic and therapeutic targets.
Lin JC, Tandar CE, Bajaj SS
… +1 more, Stanford FC
Obesity (Silver Spring)
· 2026 Apr · PMID 41724736
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OBJECTIVE: This study compared the diagnostic performance of BMI, waist circumference (WC), and Lancet Commission (LC) criteria for assessing excess adiposity measured by dual-energy X-ray absorptiometry (DEXA) in US adu...OBJECTIVE: This study compared the diagnostic performance of BMI, waist circumference (WC), and Lancet Commission (LC) criteria for assessing excess adiposity measured by dual-energy X-ray absorptiometry (DEXA) in US adults. METHODS: Using 2011-2018 NHANES data, we included 10,747 adults aged 20-59 years with relevant data. We evaluated the diagnostic performance (sensitivity, specificity, positive and negative predictive values [PPV, NPV], area under the curve [AUC]) of BMI thresholds, waist-based measures, and LC criteria for excess adiposity, as defined by DEXA. RESULTS: The weighted prevalence of DEXA-defined excess adiposity was 36.4%. CDC BMI thresholds demonstrated 74.6% sensitivity and 82.2% specificity (PPV, 67.0%; NPV, 87.0%). Waist-based measures showed higher sensitivity and lower specificity than BMI; NHLBI WC thresholds produced 88.5% sensitivity and 66.7% specificity. LC criteria performed variably: BMI plus ≥ 1 waist measure had 74.6% sensitivity and 82.2% specificity, whereas ≥ 2 waist measures had 88.5% sensitivity and 66.8% specificity. The AUC values were 0.876 for BMI, 0.882 for WC, 0.887 for waist to height ratio, and 0.715 for waist to hip ratio. CONCLUSIONS: Waist-based definitions were more sensitive than BMI, whereas BMI provided greater specificity. LC criteria performed comparably to existing definitions. Incorporating WC into screening may improve the detection of excess adiposity.
Fry HT, Gluck ME, de Baca TC
… +5 more, Stinson EJ, Unlu Y, Piaggi P, Krakoff J, Chang DC
Obesity (Silver Spring)
· 2026 Apr · PMID 41709501
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OBJECTIVE: This study aimed to assess how food-related behavioral traits, examined with the Three-Factor Eating Questionnaire (TFEQ) and the Perceived Stress Scale (PSS), influence ad libitum intake after fasting and dur...OBJECTIVE: This study aimed to assess how food-related behavioral traits, examined with the Three-Factor Eating Questionnaire (TFEQ) and the Perceived Stress Scale (PSS), influence ad libitum intake after fasting and during and after cold exposure compared to thermoneutral conditions, beyond what is explained by energy expenditure alone. METHODS: Healthy participants (n = 46; 30 males; age 36.9 ± 10.5 years; BMI 32.3 ± 8.7 kg/m) completed the TFEQ, PSS, and dual-energy x-ray absorptiometry (DXA) scan. The Hunger subscale of the TFEQ was further divided into internal and external hunger based on the methodology of Bond et al. Participants ate ad libitum from a food intake paradigm on five separate occasions, each over 24 h: (1) after a 36-h fast at thermoneutral temperature, (2) during cold exposure (19.0°C) in the chamber, (3) during thermoneutral conditions (23.5°C) in the chamber, (4) after cold exposure, and (5) after thermoneutral exposure. RESULTS: Total hunger score predicted intake across all five conditions (β = 0.58 MJ/day, p = 0.02). Internal and external subscales also predicted intake in separate models (β = 1.04 MJ/day, p = 0.02; β = 1.46 MJ/day, p = 0.01). Participants ate more during the cold condition than during thermoneutrality (mean = 1.69 MJ/day, or 404 kcal/day, p = 0.009). Higher external hunger scores correlated with greater intake (partial r = 0.38; p = 0.01), but internal hunger scores did not (partial r = 0.22, p = 0.16), after accounting for sex, race, fat mass, and fat-free mass. Restraint, disinhibition, and PSS were not associated with intake. CONCLUSIONS: Increased susceptibility to hunger cues, particularly external cues, was associated with higher food intake during cold stress. These findings suggest that behavioral approaches, such as reducing responsivity to food cues, are important targets for weight loss interventions. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02939404.
OBJECTIVE: This study evaluated impacts of vertical sleeve gastrectomy (VSG) on glycemic and cardiometabolic outcomes in youth-onset type 2 diabetes (YO-T2D). METHODS: Pre- and postoperative (3 and 12 months) anthropomet...OBJECTIVE: This study evaluated impacts of vertical sleeve gastrectomy (VSG) on glycemic and cardiometabolic outcomes in youth-onset type 2 diabetes (YO-T2D). METHODS: Pre- and postoperative (3 and 12 months) anthropometrics, mixed-meal tolerance test (MMTT) and body composition assessments, and hyperglycemic clamps (preoperative and 12 months postoperatively) were performed. RESULTS: Weight (-24.6 ± 5.2 kg at 3 months; -31.0 ± 5.2 kg at 12 months) and BMI (-8.5 ± 2.0 kg/m; -10.8 kg/m) fell by 18% and 23%, respectively (all p < 0.01). Body fat decreased 6.4% (p = 0.01) at 12 months, and fat mass by 16.8 ± 4.7 kg (p = 0.01). MMTT-stimulated GLP-1, PYY, insulin, and C-peptide secretion increased and insulin clearance, glucose, HbA1c (6.6% ± 0.2% to 5.7% ± 0.2%, p = 0.003), free fatty acids (FFA), LDL, triglycerides, adipose-focused Adipo-IR, liver transaminases and hepatic-predominant insulin sensitivity (Si) (HOMA-IR) decreased at 3 months post VSG. With maximal 12-month weight loss, MMTT-stimulated insulin, C-peptide, and GLP-1 responses attenuated, insulin clearance increased, muscle-predominant Si (hyperglycemic clamp M/I, Matsuda index, static/dynamic oral minimal modeling), β-cell function, resting heart rate, systolic blood pressure, and HDL improved, and all 3-month improvements persisted, with 86% of participants off diabetes medications. CONCLUSIONS: VSG in YO-T2D produces rapid and sustained improvements in weight, body composition, cardiometabolic health, Si, FFA, β-cell function, and glycemia, with most no longer needing diabetes medications. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03620773.