International Journal Of Obesity (2005)[JOURNAL]
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200 papers
A novel berberine derivative B12 exhibits superior anti-obesity effects via targeting brown and white adipocyte dynamics.
Zhang W, Feng Y, Gao C … +15 more , Zhong L, Wang W, Xu M, Zheng B, Zhang Y, Wang S, Yi S, Wu Z, Lin Y, Xu B, Cheng S, Zhan YY, Zhang S, Hong X, Hu T
Int J Obes (Lond) · 2026 Jul · PMID 42401759 · Publisher ↗
BACKGROUND: Obesity remains a global health challenge, with limited therapeutic options. Berberine (BBR) shows promise as an anti-obesity agent. However, its clinical application is hampered by modest efficacy and poor b...
BACKGROUND: Obesity remains a global health challenge, with limited therapeutic options. Berberine (BBR) shows promise as an anti-obesity agent. However, its clinical application is hampered by modest efficacy and poor bioavailability. OBJECTIVE: This study investigated the anti-obesity effects and underlying mechanisms of B12, a novel BBR derivative with enhanced solubility and bioavailability. METHODS: Mice with obesity induced by a high-fat-diet were employed to evaluate B12's effect on weight loss. Energy expenditure was assessed using metabolic cages. Adipose tissue morphology was examined through histological analysis. In vitro studies were conducted using 3T3-L1 preadipocytes and immortalized brown adipocytes. Gene and protein expression were analyzed using RT-qPCR, western blotting, and immunohistochemistry. Cell cycle progression was evaluated by flow cytometry. RESULTS: B12 demonstrated anti-obesity efficacy superior to BBR, manifesting through dual mechanisms. It enhanced energy expenditure by increasing brown adipocyte numbers and UCP1 expression through SIRT1 upregulation and AMPK phosphorylation. Furthermore, B12 markedly reduced the mass of white adipose tissue in mice with HFD-induced obesity and inhibited adipocyte differentiation and lipid accumulation in 3T3-L1 preadipocytes. This effect was achieved through intervention at multiple stages: early-stage downregulation of CyclinD1 and C/EBPβ, followed by reduced expression and heterodimerization of RXRα and PPARγ during middle and late stages of differentiation, collectively preventing matural adipocyte formation. CONCLUSIONS: Our findings establish B12 as a promising anti-obesity agent, offering significantly enhanced efficacy over its parent compound BBR. This natural product-derived therapeutic candidate, with its improved pharmacological properties and dual mechanism of action, represents a significant advance in phytomedicine-based approaches to obesity treatment.
The impact of glucagon-like peptide-1 receptor agonists on objective physical activity in adults: a systematic review and exploratory meta-analysis.
Kim H, Chae JH, Moon HY
Int J Obes (Lond) · 2026 Jul · PMID 42399550 · Publisher ↗
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective pharmacological treatments for obesity, through appetite suppression and weight reduction. However, their potential influence on physical activity (PA),...
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective pharmacological treatments for obesity, through appetite suppression and weight reduction. However, their potential influence on physical activity (PA), a key determinant of long-term energy balance, remains unclear. This review aimed to evaluate whether GLP-1 RA treatment affects objectively measured PA in adults with overweight or obesity. A systematic review and exploratory meta-analysis were conducted in accordance with PRISMA guidelines. PubMed and Embase were searched from inception to March 10, 2026. Eligible studies included randomized and non-randomized controlled trials examining objectively measured PA outcomes (e.g., step counts, sedentary time, and intensity-specific PA). Narrative synthesis was performed across all studies, and a random-effects meta-analysis was conducted for studies reporting comparable free-living PA outcomes. Seven studies from six independent trials (n = 924) were included. Most studies reported no statistically significant differences in PA between GLP-1 RA and control groups. However, five studies (71.4%) showed numerically lower free-living PA in GLP-1 RA-treated groups, with one study reporting a significant reduction in daily step counts (-1144 steps/day, p = 0.01). Structured exercise-related outcomes, including adherence and prescribed exercise duration, were comparable between groups. Meta-analysis of three RCTs showed no significant pooled effect (Hedges' g = -0.11, 95% CI -0.30 to 0.09, I = 0.0%). Sensitivity analyses suggested a modest reduction in PA (Hedges' g = -0.24, 95% CI -0.46 to -0.02, p = 0.035, I = 34.3%), influenced by study design and outcome heterogeneity. GLP-1 RA treatment does not significantly alter overall PA but may be associated with a small reduction in free-living PA, while structured exercise participation remains unaffected. These findings suggest a potential influence on spontaneous, non-obligatory activity rather than exercise capacity. Further studies using standardized objective PA measures are needed.
Target tissue insulin resistance in early and late onset of overweight or obesity.
Zadruzny A, Arner P, Andersson DP
Int J Obes (Lond) · 2026 Jul · PMID 42393334 · Publisher ↗
BACKGROUND/OBJECTIVE: Overweight and obesity are associated with insulin resistance. However, the importance of the time of onset of excess body fat is unknown and was presently examined. SUBJECTS/METHODS: We included 33...
BACKGROUND/OBJECTIVE: Overweight and obesity are associated with insulin resistance. However, the importance of the time of onset of excess body fat is unknown and was presently examined. SUBJECTS/METHODS: We included 339 adult participants having information about their body mass index (BMI) at 18 years of age. Insulin action was determined as homeostasis model assessment (HOMA-IR) reflecting liver, hyperinsulinemic euglycemic clamp reflecting skeletal muscle, Adipo-IR reflecting adipose tissue in vivo, and insulin action on lipogeneses reflecting fat cells. The subjects were divided into never having overweight/obesity with BMI always <25 kg/m (NO), having BMI ≥ 25 kg/m already at 18 years of age (EO), and late onset of overweight when BMI was ≥25 kg/m only at current examination (LO). The groups were compared by unpaired t-test and single and multiple regression analysis (the latter to study the influence of other factors than insulin action). RESULTS: EO had 5 kg/m higher BMI and was 10 years younger than LO at examination (p < 0.0001). EO was more insulin resistant than LO for both HOMA-IR and Adipo-IR, but not clamp (p = 0.01, 0.02, and 0.11, respectively). However, when the different measures of insulin resistance were corrected for current BMI or age there were no significant differences between EO and LO for any of the measures of insulin action (p ≥ 0.08). Furthermore, in all subjects current BMI (p < 0.0001) but not BMI when 18 years old (p ≥ 0.13) correlated with different insulin resistance measures. CONCLUSION: When current BMI or age is considered, there is no difference between early or late onset of overweight/obesity for the level of insulin resistance in the different target tissues of the hormone.
Decision tree-based prediction of 5-year weight trajectories after bariatric surgery in adolescents and young adults: a retrospective cohort study from France and Sweden.
Gueorguieva I, Lespagnol C, Saux P … +18 more , Jarvholm K, Stenberg E, Aubry E, Amsellem-Jager J, Coutant R, Dabbas M, Caiazzo R, Khen-Dunlop N, De Filippo G, Dagher I, Dubern B, Terraz C, Maggioni G, Preux P, Verkindt H, Oukhouya N, Olbers T, Pattou F
Int J Obes (Lond) · 2026 Jul · PMID 42387143 · Publisher ↗
BACKGROUND: Metabolic-bariatric surgery is an efficient therapy in selected adolescents with severe obesity. However, predicting the postoperative weight loss is challenging. A machine learning calculator predicting 5-ye...
BACKGROUND: Metabolic-bariatric surgery is an efficient therapy in selected adolescents with severe obesity. However, predicting the postoperative weight loss is challenging. A machine learning calculator predicting 5-year weight loss trajectory has been developed in adults, based on seven preoperative features. The aim of the present study was to adapt and test it in adolescents. METHODS: Retrospective cohort study in patients aged 12-20 years undergoing Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or adjustable gastric band (AGB) in France and Sweden between 2001 and 2022. Primary outcome was the accuracy of 5-year BMI prediction, expressed as the median absolute deviation (MAD) between predicted and observed BMI. The model developed in adults, was trained in a subset of 80% of randomly selected adolescents, and secondly tested in the remaining 20%. RESULTS: We enrolled a total of 2255 patients (1705 female [75.6%], 12-20 years [median 19]). Five-year follow-up data were available for 59% of French and 38% of Swedish patients. The median (IQR) 5-year total weight loss was 30.2% (23.9-38.6) for RYGB, 23.4% (13.7-32.8) for SG, and 13.4% (0.0-30.1) for AGB. The adapted model predicted the observed 5-year BMI with a MAD of 3.7 kg/m² (95% CI [3.3-3.9]). The accuracy of the model was maximal for bypass (3.2 kg/m² [3.0-3.7]), good for SG (3.9 kg/m² [3.1-5.0]), and lower for AGB (7.3 kg/m² [5.5-8.4]), and accuracy decreased with time and in adolescents under 19 years. Age, height, weight, and type of intervention influenced 5-year weight loss. Type 2 diabetes influenced weight loss until 2 years after surgery, but not later. CONCLUSION: The model had an acceptable accuracy for adolescents to predict 5-year postoperative weight loss trajectory. Accuracy decreased over time and was influenced by type of intervention and age. This calculator is available online: https://bariatric-weight-trajectory-prediction.univ-lille.fr/ .
The regulatory effects of growth hormone on adipose tissue at physiological and pathological levels and its relationship with obesity.
Liu Y, Zhu H, Yang H … +1 more , Gong F
Int J Obes (Lond) · 2026 Jul · PMID 42387142 · Publisher ↗
Growth hormone not only promotes growth and development via inducing insulin-like growth factor-1 produced by the liver but also regulates glucose and lipid metabolism of peripheral organs, including the liver, adipose t...
Growth hormone not only promotes growth and development via inducing insulin-like growth factor-1 produced by the liver but also regulates glucose and lipid metabolism of peripheral organs, including the liver, adipose tissue, and muscle. Particularly, the relationship between growth hormone and adipose tissue has been recognized since the 1950s. More intensive research focusing on it is emerging, fueled by the new conception that adipose tissue is not merely a passive reservoir for fat storage but a highly active organ with endocrine and metabolic capabilities. As for it, earlier findings have illuminated the effects of growth hormone on adipose tissue, including lipolysis and lipogenesis, adipocyte proliferation and differentiation, adipose cytokine secretion, white fat browning, and adipose tissue fibrosis. Subsequently, recent research has uncovered its involvement in promoting adipose tissue aging, regulating the adipose tissue immune microenvironment, and governing adipocyte subgroup composition. More importantly, decreased serum levels of growth hormone detected in patients with obesity are associated with glucose and lipid metabolism dysfunction. Therefore, this review aims to examine the impact of growth hormone on adipose tissue under the physiological context or pathological contexts based on patients and animal models characterized by either excessive or diminished growth hormone action to indicate a complex interplay of mutual regulatory mechanisms between adipose tissue and growth hormone. Subsequently, the alterations of growth hormone levels in obesity and their implications for glucose-lipid metabolism and adipose tissue have also been reviewed. Therefore, the review will offer novel perspectives on the role of growth hormone in the progression of obesity based on the new conception of adipose tissue and its potential use in therapeutic interventions for obesity.
Risk of metabolic dysfunction-associated steatotic liver disease and hepatic fibrosis: a large-scale study from the Middle East.
Abdelgadir E, Alawadi F, Rashid F … +2 more , Schattenberg JM, Bashir A
Int J Obes (Lond) · 2026 Jun · PMID 42380522 · Publisher ↗
There have been recent calls to increase the diagnosis rate of metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we quantified the prevalence of MASLD-associated risk factors and identified individu...
There have been recent calls to increase the diagnosis rate of metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we quantified the prevalence of MASLD-associated risk factors and identified individuals at risk of advanced fibrosis in a large, real-world cohort. This was a large, multicenter study of adults attending Dubai Academic Health Corporation between January 2018 and August 2023. MASLD risk factors were defined as the presence of one or more of the following: type 2 diabetes; obesity with ≥1 cardiometabolic risk factor; and/or raised ALT. Fibrosis-4 (FIB-4), a non-invasive index based on age, transaminases, and platelet count, was calculated, with moderate-high risk defined using established cut-offs (≥1.3 for <65 years; ≥2.0 for ≥65 years). Half (n = 46,412, 49.0%) of the population screened at risk of MASLD and, of those, 21.7% were at moderate-high risk of advanced fibrosis. 15.0% of individuals without MASLD risk factors, including those without obesity, were at moderate-high risk of fibrosis. Reliance solely on metabolic risk-based case finding may miss individuals at risk of advanced fibrosis, highlighting the value of broader fibrosis risk assessment strategies.
Expression of human endogenous retroviruses (HERVs) in the blood of adolescents with and without obesity.
Bergallo M, Rabbone I, Calvi C … +7 more , Pau A, Partenope C, Clemente A, Bellone S, Dini M, Galliano I, Tovo PA
Int J Obes (Lond) · 2026 Jun · PMID 42374121 · Publisher ↗
BACKGROUND/OBJECTIVES: Human endogenous retroviruses (HERVs) are genomic elements derived from ancient retroviral infections and are increasingly recognized for their roles in gene regulation and immune modulation. Obesi...
BACKGROUND/OBJECTIVES: Human endogenous retroviruses (HERVs) are genomic elements derived from ancient retroviral infections and are increasingly recognized for their roles in gene regulation and immune modulation. Obesity is characterized by chronic low-grade inflammation and metabolic dysregulation, which may influence HERV expression. SUBJECTS/METHODS: In this study, we evaluated the transcriptional levels of HERV-H-pol, HERV-K-pol, and HERV-W-pol in peripheral blood from adolescents with obesity as compared to healthy normal weight controls (HC). Total RNA was extracted from whole blood samples, and gene expression was assessed using quantitative reverse-transcription PCR (RT-qPCR), with GAPDH as a reference gene. RESULTS: HERV-H-pol and HERV-K-pol were significantly upregulated in adolescents with obesity as compared to HC, whereas HERV-W-pol was downregulated. No significant associations were observed between HERV expression levels and age, sex, or metabolic parameters. CONCLUSIONS: These findings suggest that obesity in adolescents is associated with a differential regulation of HERV elements, possibly reflecting the impact of chronic inflammatory and metabolic stress. HERV dysregulation may represent a novel molecular feature of obesity and warrants further investigation as a potential biomarker or contributor to obesity-related complications.
Metabolic obesity phenotypic stability, dynamic transformation and risk of hypertension: a 10-year prospective cohort study in southwest China.
Li S, Lei J, Yin L … +5 more , Li X, Zhang F, Han Y, Wang Z, Liu T
Int J Obes (Lond) · 2026 Jun · PMID 42374120 · Publisher ↗
INTRODUCTION: Hypertension is a major public health concern. Although metabolic obesity phenotypes are key risk factors for cardiovascular disease, the association between their dynamic changes and hypertension incidence...
INTRODUCTION: Hypertension is a major public health concern. Although metabolic obesity phenotypes are key risk factors for cardiovascular disease, the association between their dynamic changes and hypertension incidence remains unclear. METHODS: Based on the Guizhou Population Health Cohort Study (GPHCS), after excluding participants with hypertension at baseline or incomplete data, a total of 3399 subjects were included in the final analysis. Participants were classified into four phenotypes based on body mass index (BMI) and metabolic status: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUO). Cox proportional hazards models were applied to assess the associations between 16 phenotype transition patterns and the risk of hypertension, with robustness confirmed through multiple sensitivity analyses. RESULTS: Over a median follow-up of 6.42 years, 826 incident cases of hypertension were identified. After multivariable adjustment, compared with MHNW, baseline MHO (HR = 1.26, 95% CI: 1.02-1.55) and MUO (HR = 1.50, 95% CI: 1.22-1.82) were positively associated with hypertension risk, whereas MUNW was not (HR = 1.10, 95% CI: 0.91-1.33). Dynamic analysis showed that 48.75% of participants underwent phenotypic transitions during follow-up. The two most prominent changes were that 37.38% of individuals with MUNW transitioned to MHNW and 31.21% of those with MHO transitioned to MUO. Transitions from any baseline phenotype to MHNW were not associated with a statistically significant increase in hypertension risk (all P > 0.05). All other phenotypic transitions were positively associated. Even participants who remained MHO experienced increased hypertension risk (HR = 2.30, 95% CI: 1.45-3.64). CONCLUSION: Within the study population, MHO is an unstable state athat tended to progress to MUO, which carries the highest risk of hypertension. In contrast, the MUNW phenotype exhibits high reversibility and can revert to the MHNW phenotype. Future our studies require confirm whether early lifestyle interventions targeting metabolic health can effectively reduce the risk of hypertension.
Obesity-induced intervertebral disk degeneration: pathophysiology and clinical implications.
Bharti PS, Gorai PK, Dutt H … +4 more , Gupta Y, Malik G, Rani N, Shankar V
Int J Obes (Lond) · 2026 Jun · PMID 42374119 · Publisher ↗
Obesity is a significant public health issue that has been increasingly linked to various musculoskeletal disorders, including intervertebral disk degeneration (IVDD). The interplay between metabolic dysfunction, chronic...
Obesity is a significant public health issue that has been increasingly linked to various musculoskeletal disorders, including intervertebral disk degeneration (IVDD). The interplay between metabolic dysfunction, chronic inflammation, and biomechanical stress suggests a multifactorial link between obesity and IVDD, warranting further investigation. This review aims to explore the pathophysiological mechanisms through which obesity contributes to IVDD and discuss this relationship's clinical implications. Obesity induces an occurrence of minor chronic inflammation and metabolic abnormalities, which can exacerbate degenerative changes in the intervertebral disks. Pro-inflammatory cytokines (TNF-α and IL-6) secreted by visceral adipose tissue can promote disk degeneration by enhancing catabolic processes and inhibiting anabolic repair mechanisms within the disk matrix. Additionally, mechanical loading due to excess body weight increases stress on the spinal structures, accelerating wear and tear of the intervertebral disks. This review summarizes current research findings on the biochemical and biomechanical pathways linking obesity to IVDD. We examine evidence from epidemiological studies, clinical trials, and animal models that highlight the multifaceted impact of obesity on spinal health. Furthermore, we discuss the implications of these findings for clinical practice, emphasizing the importance of weight management in preventing and treating IVDD. Interventions such as lifestyle modifications, dietary changes, and bariatric surgery are evaluated for their effectiveness in mitigating the adverse effects of obesity on the spine. The review also addresses the potential for targeted pharmacological therapies that modulate inflammatory pathways and mechanical stress responses. Understanding the association between obesity and IVDD is crucial when establishing all-encompassing management approaches for those who are impacted by the growing global prevalence of obesity. By elucidating the pathophysiological underpinnings and clinical consequences of obesity-induced IVDD, this review aims to inform future research directions and clinical guidelines, ultimately improving patient outcomes in this growing population.
Integrating metabolic rehabilitation with incretin-based anti-obesity therapy: a narrative review of a multimodal strategy for sustainable weight loss.
Olumuyide E, Ariel K, Aneni E
Int J Obes (Lond) · 2026 Jun · PMID 42365122 · Publisher ↗
Obesity is a chronic condition associated with substantial cardiometabolic morbidity and mortality. Incretin-based anti-obesity therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-...
Obesity is a chronic condition associated with substantial cardiometabolic morbidity and mortality. Incretin-based anti-obesity therapies, including glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists, have transformed obesity management by producing clinically meaningful weight loss and improvements in glycemic and cardiometabolic risk profiles. However, weight loss achieved with these agents includes reductions in lean tissue in many studies, and the clinical significance of these body-composition changes remains incompletely defined. Importantly, reductions in DXA-derived lean mass should not be assumed to represent impaired muscle quality, strength, or function, as no published clinical trial has demonstrated that incretin-based therapy impairs muscle function. Metabolic rehabilitation encompasses structured exercise training, nutrition optimization, and behavioral support that have independently demonstrated benefits in preserving lean mass, improving insulin sensitivity, and enhancing cardiopulmonary fitness. Emerging evidence suggests that combining incretin-based therapy with metabolic rehabilitation may provide additive and complementary benefits, promote sustainable fat loss, while mitigating adverse metabolic adaptations. Metabolic rehabilitation also addresses skeletal muscle quality, bone health, and functional capacity, domains not directly targeted by pharmacologic appetite suppression. This narrative review synthesizes current evidence on the physiological effects of incretin-based obesity pharmacotherapy and metabolic rehabilitation, explores the mechanistic rationale for their combined use, reviews available clinical data, and proposes a practical framework for integrated obesity care. Key knowledge gaps and future research priorities are highlighted.
Linking circulating chemerin and adiponectin to lipoprotein subclasses measured by H-NMR spectroscopy in 3199 participants from the study of health in Pomerania.
Spindler B, Hannemann A, Völzke H … +11 more , Groß S, Bahls M, Budde K, Petersmann A, Henning AK, Winter T, Könemann S, Dörr M, Nauck M, Friedrich N, Zylla S
Int J Obes (Lond) · 2026 Jun · PMID 42362718 · Publisher ↗
BACKGROUND/OBJECTIVES: Associations between adiponectin and chemerin with the most clinically established lipid parameters for assessing cardiovascular risk - LDL-cholesterol, HDL-cholesterol, and triglycerides-are well...
BACKGROUND/OBJECTIVES: Associations between adiponectin and chemerin with the most clinically established lipid parameters for assessing cardiovascular risk - LDL-cholesterol, HDL-cholesterol, and triglycerides-are well documented. Since lipoproteins are heterogeneous with respect to size, density, and chemical composition, the examination of their subclasses could help to elucidate the complex interactions between adipokines and lipid metabolism. SUBJECTS/METHODS: Lipoprotein subclasses were quantified by nuclear magnetic resonance spectroscopy in samples from 3199 participants of the Study of Health in Pomerania (SHIP-TREND-0). Associations between adiponectin/chemerin and lipoprotein subclasses were analyzed using appropriately adjusted linear regression models. RESULTS: The analyses revealed a wide range of statistically significant associations between adiponectin/chemerin and lipoprotein subclasses, that were primarily in opposite directions. Higher adiponectin concentrations were, for example, related to a lower particle number and a lower cholesterol, phospholipid and triglyceride content in atherogenic small, dense LDL-particles, while positive associations were observed for chemerin. CONCLUSIONS: Our highly consistent results demonstrate that high adiponectin was associated with a favorable, anti-atherogenic lipoprotein profile, whereas the opposite was observed for chemerin. Whether these cross-sectional associations reflect causal mechanisms or alternatively, shared underlying metabolic processes, must be clarified by experimental and longitudinal research.
Prevalence and biopsychosocial factors associated with overweight and obesity in adults with type 1 diabetes.
Tundidor D, Blanco J, Cañizares S … +7 more , Seguí N, Obach A, Molero J, Conget I, Giménez M, Vidal J, Flores L
Int J Obes (Lond) · 2026 Jun · PMID 42362717 · Publisher ↗
BACKGROUND: To describe the prevalence of overweight and obesity in adults living with type 1 diabetes and examine the association between biopsychosocial factors according to weight status. METHODS: A single-center, cro...
BACKGROUND: To describe the prevalence of overweight and obesity in adults living with type 1 diabetes and examine the association between biopsychosocial factors according to weight status. METHODS: A single-center, cross-sectional study was conducted in adults with type 1 diabetes attending a tertiary hospital between 2018 and 2020. Participants completed an online survey with validated questionnaires to assess physical activity; measure anxiety and depression; evaluate the perception of health-related quality of life [Spanish version of Diabetes Quality of Life Questionnaire (EsDQoL)], assess eating disorders [Spanish version of Diabetes Eating Problem Survey (EPAD-R)] and measure neuroticism. Sociodemographic data and information from the last outpatient visit regarding diabetes history, long-term complications, current insulin therapy, anthropometric measurements and laboratory data were also included. RESULTS: Data from 459 surveys were available for analysis. Participants had a mean (SD) of age of 44.7 (14.0) years; 55.6% were women; BMI 26.0 (4.7) kg/m and the HbA was 7.57%. The prevalence of overweight (BMI 25-29.9 kg/m) and obesity (BMI > 30 kg/m) was 38.8% and 14.8%, respectively, with 10.6% being class I (30-34.9 kg/m), 2.2% class II (35-39.9 kg/m) and 2.0% class III (>40 kg/m). Older age, living with a child/children, a higher EPAD-R score, a higher total insulin doses, receiving lipid-lowering therapy, and a higher EsDQoL score in the diabetes-related worries dimension were associated with a greater likelihood of living with obesity. CONCLUSIONS: Overweight and obesity are highly prevalent among adults living with type 1 diabetes, and the identified biopsychosocial factors reveals how excess weight arises from complex interactions among demographic, clinical, and psychological influences.
Reassessing BMI thresholds for obesity: a population-based study in Turkish adults.
Zeynep Özsaydı S, Durmuş H, Tekdemir L … +3 more , Özsaydı S, Borlu A, Öner N
Int J Obes (Lond) · 2026 Jun · PMID 42362716 · Publisher ↗
BACKGROUND: The global prevalence of obesity has been steadily increasing, posing major public health challenges. Current universal BMI cut-off points may not accurately reflect obesity risk across different ethnicities,...
BACKGROUND: The global prevalence of obesity has been steadily increasing, posing major public health challenges. Current universal BMI cut-off points may not accurately reflect obesity risk across different ethnicities, including the Turkish population. OBJECTIVE: This study aimed to evaluate the relationship between body mass index (BMI) and body fat percentage (BF%) and determine appropriate BMI cut-off points for diagnosing obesity in Turkish adults. METHODS: A cross-sectional study was conducted among Turkish individuals aged 18-65 in four major districts of Kayseri. Anthropometric measurements were obtained, including height, weight, waist circumference, and hip circumference. Body composition was assessed using bioelectrical impedance analysis (BIA). ROC (Receiver Operating Characteristic) curve analysis was performed to identify optimal BMI cut-off points for predicting obesity based on BF%. Pearson correlation analysis evaluated the relationship between BMI and BF%. RESULTS: The participants had a mean age of 39.9 ± 13.3 years, and 51.6% were female. A strong positive correlation between BMI and BF% was found for both women (r = 0.86, p < 0.001) and men (r = 0.68, p < 0.001). The optimal BMI cut-off point for detecting obesity was 28.76 kg/m² for the total sample, 28.80 kg/m² for women, and 28.76 kg/m² for men. Using these new thresholds, the obesity prevalence increased from 27.7% to 33.6%. The AUC values indicated excellent discriminative power for women (AUC = 0.98) and good discriminative power for men (AUC = 0.91). CONCLUSION: The current universal BMI cut-off points (≥30 kg/m²) may underestimate obesity prevalence in the Turkish population. Establishing national and gender-specific BMI thresholds could improve the accuracy of obesity diagnosis and support more effective public health interventions targeting chronic non-communicable diseases.
Albuminuria: the missing therapeutic target in obesity care.
Burroughs B, Ness BM
Int J Obes (Lond) · 2026 Jun · PMID 42342954 · Publisher ↗
Abstract loading — click title to view on PubMed.
LY6D promotes hepatic steatosis via the GRB2-AMPK-SREBP1 signaling axis.
Zhao Q, Chen L, Xie S … +6 more , Meng J, Cui W, Wu Y, Zeng T, Mou H, Luo X
Int J Obes (Lond) · 2026 Jun · PMID 42332016 · Publisher ↗
BACKGROUND/OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease globally and can progress to metabolic dysfunction-associated steatohepatitis, a more se...
BACKGROUND/OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease globally and can progress to metabolic dysfunction-associated steatohepatitis, a more severe and fibrotic form. Although the recent FDA approval of Resmetirom and Semaglutide, represents a major therapeutic milestone, its efficacy is limited to a subset of patients. Thus, identifying additional molecular targets is essential. This study aimed to investigate the role of lymphocyte antigen 6 complex locus D (LY6D) in hepatic lipid accumulation and MASLD pathogenesis. SUBJECTS/METHODS: LY6D expression was assessed in liver tissue samples from patients with MASLD and validated in leptin or leptin receptor knockout mice (ob/ob and db/db) and high-fat diet-fed mouse models. Transcriptomic profiling was performed using RNA sequencing to identify LY6D-associated metabolic pathways. Functional analyses were conducted using LY6D-overexpressing mice to evaluate hepatic lipid content, gene expression, and protein signaling. Protein-protein interactions were assessed via co-immunoprecipitation, and downstream effects on AMP-activated protein kinase (AMPK) phosphorylation and sterol regulatory element-binding protein 1(SREBP1) activation were evaluated by Western blotting. RESULTS: LY6D expression was significantly elevated in liver samples from patients with MASLD and in mouse models of hepatic steatosis. Transcriptomic analysis revealed enrichment of fatty acid synthesis pathways in LY6D-high livers. In LY6D-overexpressing mice, de novo lipogenesis was increased, with upregulation of lipogenic genes including Srebf1, Fasn, Acaca, and Scd1. Mechanistically, LY6D associated with growth factor receptor-bound protein 2 (GRB2) and was accompanied by reduced AMPK phosphorylation at Thr172. Modulation of AMPK activity altered LY6D-dependent SREBP1c abundance and nuclear accumulation, supporting an LY6D-associated GRB2-AMPK-SREBP1c regulatory node that promotes lipogenic transcription. CONCLUSIONS: LY6D is an upstream regulator of hepatic de novo lipogenesis in MASLD. Our data support a model in which LY6D promotes lipogenic signaling via an LY6D-associated GRB2-AMPK-SREBP1c pathway, and suggest that LY6D may represent a therapeutic entry point to complement current MASLD/MASH treatments. LY6D was found to bind GRB2, leading to suppression of AMPK phosphorylation at Thr172. This inhibition promoted transcription and nuclear translocation of SREBP1, thereby enhancing transcription of key lipogenic genes (Acaca, Fasn, and Scd1) and consequently increasing hepatic de novo lipogenesis.
Effect of GLP-1 receptor agonists at doses for obesity management on muscle health: systematic review and meta-analysis of randomized controlled trials (RCTs).
Laverde LP, Muñoz-Velandia OM, Alfonso D … +1 more , Gómez Medina AM
Int J Obes (Lond) · 2026 Jun · PMID 42321502 · Publisher ↗
INTRODUCTION: The impact of GLP-1 receptor agonists (GLP1-RA) treatment on lean mass and body composition in patients with obesity is not fully understood. METHODOLOGY: Systematic review and meta-analysis of RCTs includi...
INTRODUCTION: The impact of GLP-1 receptor agonists (GLP1-RA) treatment on lean mass and body composition in patients with obesity is not fully understood. METHODOLOGY: Systematic review and meta-analysis of RCTs including patients with obesity treated with GLP1-RA at obesity doses, compared with placebo. Search was conducted in PubMed, Embase, and LILACS in March 2025. A meta-analysis was performed using a random-effects model to evaluate the change in lean mass as a proportion of total weight, the absolute and relative changes in lean mass, and adverse effects. RESULTS: Seven studies (821 patients) were included in the analysis. GLP1-RA significantly improved lean mass as a proportion of total weight, with an observed increase of 1.81% (95% CI: 1.1- 2.52; p < 0.00001; I² = 7%). However, a significant decrease was observed in the absolute change in lean mass (-1.74 kg; 95% CI: -3.04 to -0.45; p < 0.00001; I² = 98%) and in the percentage of lean mass (-3.06%; 95% CI: -5.10 to -1.02; p < 0.00001; I² = 98%). Semaglutide demonstrated the most significant reduction in absolute lean mass, with a loss of -5.44 kg (95% CI: -7.07 to -3.81; p < 0.00001). CONCLUSIONS: There is an improvement in body composition due to an increase in lean mass as a proportion of total weight, an effect that could be amplified with the use of semaglutide. Our results suggest that lean mass loss should not be considered a limitation for the use of these drugs in patients with obesity. However, it is essential to accompany drug treatment with nutritional and physical exercise interventions to preserve or improve muscle mass and optimize clinical outcomes.
Toward an intergenerational model of metabolic and bariatric surgery: reframing the household as the unit of care.
Vidmar AP, Samakar K, Martin MJ … +1 more , Morton JM
Int J Obes (Lond) · 2026 Jun · PMID 42315727 · Publisher ↗
Obesity is a chronic, relapsing disease that increasingly spans generations within households, yet contemporary metabolic and bariatric surgery (MBS) models remain oriented toward individuals or single-generation patient...
Obesity is a chronic, relapsing disease that increasingly spans generations within households, yet contemporary metabolic and bariatric surgery (MBS) models remain oriented toward individuals or single-generation patients. A growing body of evidence demonstrates that obesity risk, behaviors, and treatment responses cluster within family systems, and that MBS produces measurable metabolic and behavioral effects among untreated spouses, partners, and children. Concurrently, decades of pediatric research confirm that caregiver engagement and integration is one of the strongest determinants of successful obesity treatment. Together, these observations support a paradigm shift toward an intergenerational, family-centered model of MBS, in which the household becomes the unit of care. This perspective synthesizes evidence supporting the biological, behavioral, and environmental interdependence of obesity within families and outlines a comprehensive framework for implementing household-level bariatric care. Core components include integrated pediatric-adult clinical infrastructure; combined multidisciplinary teams trained across the age spectrum; harmonized protocols for evaluation, education, and follow-up; coordinated scheduling and workflow alignment; and family-based behavioral strategies that promote shared goals, consistent routines, and mutual accountability. Operational and policy innovations, such as cross-departmental agreements, unified electronic health records, and coordinated billing can facilitate sustainable implementation. We further identify research priorities, including quantifying metabolic ripple effects among untreated family members, evaluating bundled household-level interventions, and developing validated metrics to assess changes in the home environment. Treating the household as the patient offers a promising strategy to enhance medical obesity treatment, surgical durability, improve adherence, and disrupt intergenerational transmission of obesity. As obesity increasingly presents as a family condition, an intergenerational MBS model may help realign treatment with the realities of lived experience and improve outcomes across generations.
Cardiovascular disease and metabolic dysfunction-associated steatotic liver disease incidence in metabolically healthy and unhealthy normal weight obesity.
Johnson PR, Keirns BH, Meade GE … +7 more , Huizinga PA, Kim AY, Sigdel R, Cardona CJ, Montgomery MR, Emerson SR, Chowanadisai W
Int J Obes (Lond) · 2026 Jun · PMID 42310388 · Publisher ↗
BACKGROUND: Normal weight obesity (NWO) is characterized by a normal body mass index (BMI) and elevated body fat. Heterogeneous risk has been observed in people with obesity (BMI > 30) when considering metabolic risk fac...
BACKGROUND: Normal weight obesity (NWO) is characterized by a normal body mass index (BMI) and elevated body fat. Heterogeneous risk has been observed in people with obesity (BMI > 30) when considering metabolic risk factors (MRFs) such as high C-reactive protein, low-density lipoprotein, blood pressure, hemoglobin A1C, triglycerides, and low high-density lipoprotein. OBJECTIVES: We assessed heterogeneity between metabolically healthy (MH) and metabolically unhealthy (MU) subjects with NWO in relation to (1) incident cardiovascular disease (CVD) and metabolic dysfunction-associated steatotic liver disease (MASLD) along with (2) changes in heart physiology, liver function (assessed with imaging), and cardiometabolic/liver serum biomarkers. METHODS: In total, 121,586 subjects were classified into the following experimental groups: a healthy normal weight lean reference group ( ≤ 2 MRFs), MH-NWO ( ≤ 2 MRFs), MU-NWO ( > 2 MRFs), and people with overweight/obesity (OW/O) were classified as MH-OW/O ( ≤ 2 MRFs) or MU-OW/O ( > 2 MRFs). Primary outcomes were incident CVD and MASLD analyzed using Firth logistic regression and displayed via odds ratios (OR) and 95%-confidence intervals (95%-CI). Secondary outcomes were cross-sectional cardiac/liver imaging, serum liver enzyme, and lipid biomarkers analyzed using quantile regression. Results were deemed significant at false discovery rate (FDR) < 0.05. RESULTS: MU-NWO had higher odds of ischemic heart disease (OR 1.68, 95%-CI 1.36-2.05, FDR = 0.000007), myocardial infarction (OR 1.72, 95%-CI 1.38-2.11, FDR = 0.000007), all-cause mortality (OR 1.29, 95%-CI 1.05-1.56, FDR = 0.02), and CVD death (I0-I99); (OR 1.86, 95%-CI 1.27-2.64, FDR = 0.0036) while MH-NWO saw no significant differences. Among female subjects, both MH-NWO (OR 1.37, 95%-CI 1.04-1.78, FDR = 0.03) and MU-NWO (OR 1.78, 95%-CI 1.05-2.83, FDR = 0.03) had increased odds of MASLD. Biochemical and imaging data were consistent with enhanced CVD and MASLD risk. CONCLUSION: MRFs may modulate CVD and MASLD risk in NWO.
Alcohol use disorders and related morbidity and mortality after sleeve gastrectomy and Roux-en-Y gastric bypass: a nation-wide registry study (the BAR-REGISTER).
Strømmen M, Bakken IJ, Sandvik J … +2 more , Bramness JG, Klöckner C
Int J Obes (Lond) · 2026 Jun · PMID 42310387 · Publisher ↗
BACKGROUND: Bariatric surgery provides notable weight loss and metabolic benefits but may also increase the risk of alcohol use disorder (AUD). We investigated whether Roux-en-Y gastric bypass (RYGB) confers higher rates...
BACKGROUND: Bariatric surgery provides notable weight loss and metabolic benefits but may also increase the risk of alcohol use disorder (AUD). We investigated whether Roux-en-Y gastric bypass (RYGB) confers higher rates of AUD and related disorders than sleeve gastrectomy (SG) and examined associated morbidity and mortality. METHODS: We conducted a retrospective, population-based cohort study using data from the Norwegian Patient Registry and the Norwegian Prescription Database. A total of 17,800 patients underwent RYGB (n = 12,244) or SG (n = 5556) between 2008 and 2018. Patients with prior diagnoses related to alcohol or use of medications for AUD were excluded. Incidence rates (IR) for alcohol-related diagnoses were calculated per 1000 person-years; hazard ratios (HR) were derived comparing RYGB to SG. Morbidity was measured as number of specialized healthcare contacts, but also as number of prescriptions/defined daily doses in an exploratory model. RESULTS: Mean postoperative follow-up was 5.7 years (RYGB) and 3.8 years (SG). By 31 December 2018, 576 patients (3.2%) had developed a new alcohol-related diagnosis - an incidence rate of 6.34 per 1000 person-years. The adjusted HR for such diagnoses was 1.69 (95% CI 1.33-2.13, p < 0.001) for patients undergoing RYGB compared to SG. Because mortality did not differ significantly between RYGB and SG, mortality was assessed for the cohort as a whole: patients with alcohol-related diagnoses had an adjusted HR for death of 2.08 (95% CI 1.40-3.08) relative to those without. They also recorded, on average, 5.5 additional contacts in specialist care. CONCLUSIONS: Compared with SG, RYGB was associated with a 69% higher risk of alcohol-related diagnoses. Further, given the elevated morbidity and mortality linked to these disorders, enhanced preoperative screening and long-term postoperative monitoring are warranted in modern bariatric practice.
Ethanol pharmacokinetics before and after sleeve gastrectomy and Roux-en-Y gastric bypass: a 3 year prospective study (the BAR-TRIAL).
Strømmen M, Dale O, Klöckner C … +1 more , Tylleskär I
Int J Obes (Lond) · 2026 Jun · PMID 42310386 · Publisher ↗
OBJECTIVES: To compare ethanol pharmacokinetics before and after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) over a three-year period. METHODS: This was a prospective, longitudinal, non-randomized control...
OBJECTIVES: To compare ethanol pharmacokinetics before and after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) over a three-year period. METHODS: This was a prospective, longitudinal, non-randomized controlled study at St. Olavs Hospital, Trondheim, including 33 adults without histories of alcohol use disorder (RYGB: n = 14; SG: n = 19). Participants underwent oral and intravenous ethanol challenge tests preoperatively and at 3, 12, and 36 months postoperatively. Primary outcomes included maximum plasma concentration (C), time to reach maximum concentration (T), and area under the curve to the last measurable concentration (AUC). RESULTS: The ethanol uptake after both surgical procedures was bioequivalent for AUC, but not for C and T. At 12 months, RYGB gave a 27% higher C and 31% shorter T than SG, while no significant differences were observed for AUC. Both procedures induced profound and persistent alterations in ethanol pharmacokinetics over the three-year period: C and AUC approximately doubled, and T was reduced to about half the preoperative value. C occurred within 9-15 min compared to 25-29 min before surgery. Patients also had concomitant reductions in total body water, averaging 3.2 kg after SG and 4.8 kg after RYGB at 12 months. CONCLUSION: Both RYGB and SG permanently altered ethanol pharmacokinetics, resulting in faster absorption, higher peak concentrations, and higher systemic exposure of alcohol. These changes, which were more pronounced after RYGB, may increase the risk of alcohol use disorders post-surgery. Awareness of the pharmacokinetic effects on RYGB and SG may be relevant for patient education, surgical decision-making, and postoperative monitoring. CLINICAL TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov on May 15 2013. Identifier: NCT01840020.
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