International Journal Of Obesity (2005)[JOURNAL]
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200 papers
Results of the 2024 International Weight Bias Summit: Establishing future research directions in the field.
Côté M, Forouhar V, Sacco S … +12 more , González-González M, Baillot A, Himmelstein M, Hussey B, Incollingo Rodriguez AC, Nagpal TS, Nutter S, Patton I, Puhl RM, Ramos Salas X, Russell-Mayhew S, Alberga AS
Int J Obes (Lond) · 2026 Mar · PMID 41350605 · Full text
BACKGROUND: Weight bias is a social justice issue that manifests in social and health inequities, affecting the lives of millions of individuals globally. Although weight bias research has increased over the last two dec...
BACKGROUND: Weight bias is a social justice issue that manifests in social and health inequities, affecting the lives of millions of individuals globally. Although weight bias research has increased over the last two decades, it remains pervasive, and more work is needed to establish effective strategies to reduce it. The 2024 International Weight Bias Summit aimed to collaboratively identify future research directions for prioritization as well as perceived barriers in the global field of weight bias and stigma. This paper presents the primary findings from the Summit. METHOD: Experts in weight bias (N = 33 researchers, clinicians, representatives of professional/national organizations with interests in weight bias and stigma, and individuals with lived experiences) from across North and Latin America, Europe, and Australia attended the two-day Summit. Attendees participated in semi-structured small group discussions using the Nominal Group Technique (NGT). Notes were collected from all discussions and thematically analyzed to identify the most prominent research directions and barriers that emerged from the Summit. RESULTS: Experts identified six key research directions (presented without hierarchical ranking): (1) consequences of weight bias, (2) conceptual and methodological clarity, (3) diversity in sampling, cultures, and settings, (4) interventions, (5) policy, and (6) implementation science. Three key barriers were also identified in weight bias and stigma research: (1) widespread misconceptions and lack of recognition of weight bias as a legitimate issue, (2) funding challenges, and (3) lack of collaborations and working in silos. CONCLUSION: Experts identified six critical research directions that should be prioritized to advance weight bias and stigma research and drive meaningful progress. Continued international collaboration was recognized as essential to driving this work forward.
Long-term impact of newly-proposed clinical obesity on autoimmune disease incidence: insights from the UK Biobank.
Xu M, Li M, Zhang Y … +3 more , Li L, Shen Y, Hu G
Int J Obes (Lond) · 2026 Mar · PMID 41326745 · Full text
BACKGROUND/OBJECTIVES: The definition of clinical obesity was newly announced. The aim of our study was to investigate the association of preclinical obesity and clinical obesity either at baseline or determined during f...
BACKGROUND/OBJECTIVES: The definition of clinical obesity was newly announced. The aim of our study was to investigate the association of preclinical obesity and clinical obesity either at baseline or determined during follow-ups with the risk of autoimmune diseases (s) incidence. SUBJECTS/METHODS: Data were collected from 229,190 participants in the UK Biobank. Dysfunctions caused by obesity, in combination with anthropometric parameters, were used to diagnose clinical obesity. Seven prevalent ADs were analysed, including seropositive rheumatoid arthritis (PRA), psoriasis (PSO), multiple sclerosis (MS), systemic lupus erythematosus (SLE), myasthenia gravis (MG), Crohn's disease (CD), and ulcerative colitis (UC). According to obesity and dysfunction status, participants were categorized into six clusters. Time-dependent Cox model was used to compare hazard ratios (HRs) for ADs incidence across six clusters. RESULTS: In a total of 4938 ADs incidence events over a mean follow-up of 13.3 years, participants in Cluster 6 (clinical obesity at baseline; HR = 2.48, 95% CI: 2.222.78) and Cluster 3 (non-obesity and dysfunction at baseline; HR = 2.16, 95% CI: 1.83-2.55) exhibited the highest multivariable-adjusted mortality risk compared with participants without obesity and dysfunction at baseline and during follow-up (Cluster 1). Specific ADs analyses showed consistently higher incidence risks in Cluster 6, notably in PSO and PRA (HR = 4.31, 95% CI: 3.58-5.19 and HR = 3.63, 95% CI: 2.54-5.18, respectively). CONCLUSION: Clinical obesity was significantly associated with elevated ADs incidence risk. These findings underscore the importance of early screening and intervention of clinical obesity and dysfunctions due to obesity.
Gene-environment interplay explaining individual variation in BMI outcomes: a systematic review and meta-analysis of studies using polygenic indices.
de Roo M, Hartman CA, Wiertsema M … +1 more , Kretschmer T
Int J Obes (Lond) · 2026 Feb · PMID 41318678 · Publisher ↗
BACKGROUND: Genetic and environmental factors are both associated with weight outcomes, but it remains unclear to what extent environmental exposures are consistently associated beyond genetic predisposition, and to what...
BACKGROUND: Genetic and environmental factors are both associated with weight outcomes, but it remains unclear to what extent environmental exposures are consistently associated beyond genetic predisposition, and to what extent they modify genetic risk. METHODS: We meta-analyzed evidence on gene-environment interplay and individual variation in BMI and related outcomes, focusing on peer-reviewed studies examining environmental exposures and using polygenic indices for BMI. Six electronic databases (APA PsycArticles, APA PsycInfo, ERIC, MEDLINE, Psychology and Behavioral Sciences Collection, SocINDEX) were searched through April 2025. Risk of bias was assessed using a modified Newcastle-Ottawa Scale and quality criteria for gene-environment interaction studies. RESULTS: The meta-analysis included 1161 estimates from 88 studies: 153 estimates of main genetic associations, 283 of associations between environmental factors and BMI outcomes controlling for a polygenic index for BMI, and 725 of gene-environment interactions (G×E). Genetic predisposition for BMI was positively associated with BMI for all ancestry groups. The overall association between environmental exposures and BMI, controlling for genetic risk, was r = 0.12 (p < 0.001; 95% CI: 0.08 to 0.16) for both European and combined ancestry groups. Overall G×E effects ranged from r = 0.06 to 0.12 (all p < 0.001), depending on ancestry group and whether imputed effect sizes were included. Separate meta-analyses by type of environmental exposure yielded overall associations that were largely comparable in magnitude, consistent with moderation analyses indicating that there were no significant differences in effect sizes across different exposure categories. CONCLUSIONS: This meta-analysis highlights the importance of both genetic and environmental factors in explaining variation in BMI. Most studies did not account for gene-environment correlation confounding and focused primarily on European ancestry populations. Future research should prioritize methodologies that address bias and focus on underrepresented ancestry groups to improve inclusivity.
Current evidence and future perspectives on magnet-assisted bariatric surgery (MABS): a systematic review.
Chen Y, Shiliang D, Liu Y … +5 more , Zhou X, Wu B, Zhang X, Chen W, Dong Z
Int J Obes (Lond) · 2026 Feb · PMID 41315751 · Publisher ↗
BACKGROUND: Magnet-assisted bariatric surgery (MABS) represents a novel advancement in minimally invasive surgical techniques. It addresses challenges associated with obesity-related anatomical complexities, such as hepa...
BACKGROUND: Magnet-assisted bariatric surgery (MABS) represents a novel advancement in minimally invasive surgical techniques. It addresses challenges associated with obesity-related anatomical complexities, such as hepatomegaly and fatty liver disease, by enhancing surgical exposure and site visualization. OBJECTIVES: This systematic review aimed to: (1) compare the efficacy of MABS and conventional bariatric surgery for weight loss and postoperative outcomes; (2) assess their safety profiles; and (3) evaluate perioperative recovery, hospital stay, and patient-reported outcomes like quality of life and satisfaction. METHODS: A comprehensive literature search was conducted across PubMed, Web of science, Google scholar and Cochrane databases. Data were extracted and synthesized to provide quantitative assessment of MABS's performance. RESULTS: A total of 12 articles comprising 1305 participants were included. The findings confirmed MABS's feasibility and safety, with significant advantages across varying BMI ranges. Notable benefits included improved surgical exposure, shorter or comparable operative times, reduced postoperative pain, shorter hospital stays, low complication rates and no procedure-related mortality. CONCLUSION: MABS demonstrated strong potential as an innovative tool in minimally invasive bariatric surgery, offering significant benefits for both patients and surgical teams. Its ability to address obesity-related challenges and enhance surgical outcomes supports its continued use and refinement. Future research should focus on stratified analyses, long-term outcomes, and economic evaluations to establish standardized criteria for patient selection and expand its applicability to other minimally invasive procedures.
The association between antibiotic use in infancy and overweight during childhood and adolescence: a historical cohort study.
Heyman E, Chodick G, Fallach N … +1 more , Dubnov-Raz G
Int J Obes (Lond) · 2026 Mar · PMID 41315750 · Publisher ↗
BACKGROUND AND OBJECTIVE: The role of the microbiome and gut flora alterations in childhood obesity has drawn increasing scientific attention. However, large-scale, long-term cohort studies with real-world data on exposu...
BACKGROUND AND OBJECTIVE: The role of the microbiome and gut flora alterations in childhood obesity has drawn increasing scientific attention. However, large-scale, long-term cohort studies with real-world data on exposure and outcomes are lacking. We aimed to examine the association between exposure to antibiotics during infancy and the development of overweight and obesity during childhood and adolescence. METHODS: We conducted a historical cohort study using data from a large Israeli health provider (Maccabi Healthcare Services, MHS). Eligible patients born between 1998-2002 who received antibiotics before age 2 years were compared with unexposed infants. Valid body mass index (BMI) data were available for 76,840 eligible infants, including 65280 exposed to antibiotics (52.2% males) and 11,560 unexposed (46.1% males). Study outcomes were overweight and obesity during childhood/ adolescence. RESULTS: Compared to unexposed, antibiotic-exposed infants had significantly higher mean ( ± SE) BMI percentiles in all age groups: childhood (57.8 ± 0.1 vs 55.0 ± 0.2), early adolescence (58.2 ± 0.1 vs. 55.1 ± 0.3), and late adolescence (57.4 ± 0.2 vs. 55.0 ± 0.4), all p < 0.001. The odds of overweight and obesity versus unexposed infants increased significantly (p < 0.001) with the number of dispensed narrow-spectrum antibiotic packs, from an odds ratio of 1.15 (95%CI: 1.02-1.29) for 1-2 packs, to 1.52 (95%CI: 1.13-2.05) among those exposed to 10 or more packs. No such association was found for broad-spectrum antibiotics. CONCLUSIONS: Exposure to narrow spectrum antibiotics during infancy was associated with a higher BMI and an increased likelihood of overweight and obesity in childhood and adolescence.
Post-intervention sustainability of time-restricted eating versus caloric restriction: a secondary analysis.
Chen DA, Pena RH, Oldenburg N … +8 more , Wang Q, Helgeson E, Yentzer B, Taddese A, LaPage N, Manoogian ENC, Panda S, Chow LS
Int J Obes (Lond) · 2026 Feb · PMID 41315749 · Full text
Rising obesity rates necessitate sustainable weight management strategies. Current lifestyle guidelines focus on reducing caloric intake through personalized interventions to promote compliance. This secondary analysis e...
Rising obesity rates necessitate sustainable weight management strategies. Current lifestyle guidelines focus on reducing caloric intake through personalized interventions to promote compliance. This secondary analysis evaluated post-intervention sustainability of time-restricted eating (TRE) versus caloric restriction (CR), hypothesizing that TRE's "watching the clock" approach may be more sustainable than CR's "watching calories." Following a 12-week supervised intervention (TRE: 8-h eating window, n = 29; CR: 15% caloric reduction, n = 26), 41 participants (75%; 24 F/17 M; 23 TRE/18 CR; age 43.1 ± 11.6 years; BMI 34.7 ± 5.4 kg/m²) completed follow-up surveys at 1, 3, and 6 months. TRE participants maintained weight across all follow-ups compared to final intervention weight. CR participants showed significant loss at 1 month (-1.6 ± 2.5 kg, p = 0.02), returning to baseline by 3 months. Both interventions had similar continuation rates (1,3,6 months: TRE: 52%, 36%, 47%; CR: 63%, 57%, 50%; p = 0.60) and recommendation rates (TRE: 81%, 85%, 86%; CR: 88%, 86%, 80%; p = 0.72). TRE participants reported improved sleep, energy, and digestion but experienced morning hunger and scheduling challenges. CR participants noted increased food mindfulness but reported tracking anxiety, cravings, and potential binge eating. Despite limitations including small sample size and self-reported weight, both self-sustained TRE and CR showed similar acceptability and weight maintenance at 3-6 months post-intervention. Clinical Trial Registration: Clinicaltrials.gov NCT04259632.
The effect of berberine on obesity indices: a systematic review and meta-analysis.
Elahi Vahed I, Shahir-Roudi E, Nojumi S … +9 more , Golmohammadi S, Moradi Shahrebabak M, Sharafi Tafreshi Moghadam N, Bagheryan AS, Moftakhar M, Shamsipour F, Jafari M, Soltaninejad H, Rahmanian M
Int J Obes (Lond) · 2026 Jan · PMID 41310257 · Publisher ↗
BACKGROUND AND AIM: Obesity is an already identified risk factor for various noncommunicable diseases. Berberine is an alkaloid that has manifested a significant effect in the treatment of obesity and its complications....
BACKGROUND AND AIM: Obesity is an already identified risk factor for various noncommunicable diseases. Berberine is an alkaloid that has manifested a significant effect in the treatment of obesity and its complications. The aim of this systematic review and meta analysis is to evaluate the effect of berberine on obesity indices. METHODS: We conducted a comprehensive search of Scopus, PubMed, Web of Science, and Google Scholar for randomized controlled trials (RCTs) investigating berberine's impact on obesity indices in adults. Eligible studies included human trials with quantitative outcomes for weight, BMI, WC, or WHR. Animal studies, reviews, and non-RCTs were excluded. Two reviewers independently screened studies, extracted data, and assessed risk of bias using the Cochrane RoB 2 tool. A random-effects meta-analysis was performed to calculate mean differences (MDs) and 95% confidence intervals (CIs). Heterogeneity was evaluated using I² statistics. RESULTS: A total of 23 articles were included. Berberine significantly reduced body weight (MD of -0.88 kg, 95% CI: -1.36 to -0.39, p = 0.0003), BMI (MD of -0.48 kg/m², 95% CI: -0.89 to -0.07, p < 0.0216), and WC (MD of -1.32 kg/m², 95% CI: -2.24 to -0.41, p < 0.0046). However, berberine did not significantly reduce WHR compared to control groups (MD of -0.01, 95% CI: -0.03 to 0.01). Meta-regression revealed no association between berberine use and age. CONCLUSION: Berberine use significantly reduces body weight, BMI, and WC but does not significantly reduce WHR. Future trials should focus on improving reporting standards for biochemical characterization (such as purity, potency and gram amounts) and address common biases such as lack of blinding and randomization to enhance the reliability of the evidence.
Dietary Inflammatory Index and Mediterranean Diet Score are associated with systemic inflammation in women with lipedema.
Tel Adıgüzel K, Yaman A, Kürklü NS … +1 more , Adıgüzel E
Int J Obes (Lond) · 2026 Feb · PMID 41310256 · Publisher ↗
BACKGROUND/OBJECTIVES: Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation, pain, and low-grade systemic inflammation, primarily affecting women. This study investigated the r...
BACKGROUND/OBJECTIVES: Lipedema is a chronic adipose tissue disorder characterized by disproportionate fat accumulation, pain, and low-grade systemic inflammation, primarily affecting women. This study investigated the relationship between the Dietary Inflammatory Index (DII), adherence to the Mediterranean diet scores (MDS), inflammatory biomarkers (TNF-α and IL-6), and clinical outcomes in women with lipedema. SUBJECTS/METHODS: A cross-sectional study was conducted on 60 female participants with stage 2-3 lipedema and BMI between 30-40 kg/m². Using three-day dietary records, DII was calculated. MDS was measured by Mediterranean Diet Adherence Screening Tool. Pain and quality of life were evaluated using the Visual Analog Scale (VAS) and the Short Form-12 (SF-12), respectively. Body composition was measured via bioelectrical impedance analysis, and serum TNF-α and IL-6 levels were measured using ELISA. RESULTS: DII score was positively associated with elevated TNF-α and IL-6 concentration (p < 0.001). DII was moderately and positively correlated with both inflammatory markers, while MDS showed moderate negative correlations. Multiple linear regression models identified DII, MDS, and body mass index (BMI) as significant predictors of TNF-α and IL-6 concentration. No significant associations were observed between DII or MDS and pain (VAS) or quality of life (SF-12) scores, although mental component scores were slightly higher in participants with moderate DII levels compared to those with higher DII levels. Higher DII and BMI were linked to increased inflammation, while higher MDS was associated with lower biomarker levels. Age and disease duration were not significant in any model. CONCLUSIONS: A pro-inflammatory diet, as reflected by higher DII, is associated with increased systemic inflammation in lipedema. These findings highlight the potential role of anti-inflammatory dietary patterns, particularly the Mediterranean diet, as part of non-pharmacological strategies for managing inflammation in lipedema. These findings suggest that while dietary inflammatory potential influences systemic inflammation, its relationship with pain and quality of life remains unclear and warrants further interventional studies.
Optimal BMI cut-offs associated with cardiometabolic risks in Arab and Middle Eastern populations: a systematic review and meta-analysis.
Al Busaidi S, Al-Maqbali JS, Al Nou'mani J … +3 more , Al Harthi T, Al Alawi AM, Al Kharusi A
Int J Obes (Lond) · 2026 Jan · PMID 41291021 · Publisher ↗
BACKGROUND: The global rise in obesity has prompted the need to explore population-specific Body Mass Index (BMI) thresholds. Current international guidelines may not reflect the cardiometabolic risks in Arab and Middle...
BACKGROUND: The global rise in obesity has prompted the need to explore population-specific Body Mass Index (BMI) thresholds. Current international guidelines may not reflect the cardiometabolic risks in Arab and Middle Eastern populations. This systematic review and meta-analysis aim to identify optimal BMI cut-offs associated with cardiometabolic morbidity and mortality in these populations. METHODS: A systematic search of Medline and Embase databases identified observational and experimental studies focusing on BMI thresholds linked to cardiometabolic outcomes, including Diabetes Mellitus (DM), hypertension (HTN), dyslipidemia (DLP), cardiovascular diseases (CVD), and metabolic syndrome. Data extraction followed PRISMA guidelines, and random-effects models were used to calculate pooled estimates of optimal BMI cut-offs. Subgroup and sensitivity analyses were performed to address heterogeneity. RESULTS: Fifty-five studies involving 677,587 participants met the inclusion criteria. Optimal BMI cut-offs ranged from 26.22 to 27.45 kg/m². For DM, the BMI threshold was 27.39 kg/m² (95% CI: 26.70-28.09), while HTN and MetS were associated with thresholds of 27.00 kg/m² and 27.45 kg/m², respectively. Gender differences were observed, with females showing higher BMI cut-offs than males. The sensitivity and specificity of these cut-offs were moderate, with high between-study heterogeneity (I² > 90%). Publication bias was minimal for most outcomes, except DLP. CONCLUSION: This study demonstrates that lower BMI thresholds are associated with cardiometabolic risks in Arab and Middle Eastern populations compared to global reports. Findings support the need for region-specific BMI cut-off guidelines and public health interventions targeting early diagnosis and management.
Optimizing adipogenic cocktail composition to enhance beige adipogenesis and evaluate thermogenic potential in primary mouse subcutaneous fat cell cultures.
Ma Y, Zhang Z, Ramos ET … +4 more , Martin E, Gunukula R, Sprabary K, Jun H
Int J Obes (Lond) · 2026 Feb · PMID 41286427 · Full text
BACKGROUND: Subcutaneous white adipose tissue (WAT) is crucial for systemic metabolic homeostasis, with beige adipocytes in this depot contributing to energy metabolism through inducible thermogenesis. Differentiated adi...
BACKGROUND: Subcutaneous white adipose tissue (WAT) is crucial for systemic metabolic homeostasis, with beige adipocytes in this depot contributing to energy metabolism through inducible thermogenesis. Differentiated adipocyte cultures derived from mouse inguinal WAT are a widely used system to study beige adipose biology and identify therapeutic targets, as they retain the genetic and epigenetic traits of native adipocytes while providing experimental flexibility. However, variability during the adipocyte induction and differentiation poses a challenge, impacting beige adipogenesis and experimental outcomes. METHODS: This study conducted an unbiased analysis of four distinct adipogenic cocktails to evaluate their effects on beige adipogenesis in inguinal stromal vascular fraction cells from wild-type and genetically modified mice, as well as on the thermogenic activation of differentiated adipocytes. RESULTS: Different combinations of adipogenic inducers, including dexamethasone, 3-isobutyl-1-methylxanthine, insulin, triiodothyronine, indomethacin, and rosiglitazone (Rosi), recruited beige adipocytes with varying levels of thermogenic characteristics. The peroxisome proliferator-activated receptor gamma agonist, Rosi, emerged as a key inducer, maximizing beige adipocyte biogenesis during the differentiation phase rather than the induction phase. However, Rosi-enhanced beige adipocyte differentiation exhibited limited thermogenic activation at the transcriptional level but not at the rapid signal transduction and real-time functional level in response to a β-adrenergic receptor agonist. CONCLUSIONS: These findings underscore the importance of optimizing adipogenic cocktails, as they significantly influence experimental outcomes. This study offers valuable guidance for selecting effective combinations of adipogenic inducers tailored to specific research objectives and relevant in vitro models of beige adipose biology.
Serum S100β and neuron-specific enolase correlate with obesity parameters in Mexican children.
Hurtado-Alvarado G, Mendez-Hernandez R, Avila-Soto KI … +5 more , Salazar-Juárez A, Espinoza-Rojo M, Escobar C, Vázquez-Moreno M, Cruz M
Int J Obes (Lond) · 2026 Feb · PMID 41286426 · Full text
BACKGROUND: Circulating S100 β and neuron-specific enolase (NSE) have been used to explore brain damage in adults with obesity. Nonetheless, the subtle increase of these molecules can be found in non-pathological conditi...
BACKGROUND: Circulating S100 β and neuron-specific enolase (NSE) have been used to explore brain damage in adults with obesity. Nonetheless, the subtle increase of these molecules can be found in non-pathological conditions in healthy subjects, indicating possible disturbances in brain function. OBJECTIVE: We aimed to compare serum levels of S100β and NSE between children with and without obesity. SUBJECTS AND METHODS: We analyzed circulating S100β and NSE and performed correlations with anthropometry and biochemical parameters from 80 children between 6 and 11 years old, divided into two groups: children with obesity (Body mass index ≥97th percentile) and children with normal body weight (between the 5th and 85th percentile). RESULTS: Our results show that children with obesity have approximately 50% more circulating levels of S100β and NSE. Furthermore, we found a positive correlation between S100β and circulating resistin and a positive correlation between NSE and Body mass index, waist circumference, and waist-to-hip ratio. Conversely, NSE and adiponectin showed a negative correlation. CONCLUSION: S100β and NSE levels in blood were associated with indicators of metabolic impairment. Future studies are needed to determine if the increase of S100β and NSE in children with obesity is related to cognitive function.
Correction: The nature of the relationship between obesity and mental health: an IMI2 SOPHIA qualitative study.
Farrell E, Nadglowski J, Hollmann E … +2 more , le Roux CW, McGillicuddy D
Int J Obes (Lond) · 2026 Mar · PMID 41275007 · Full text
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Metabolic bariatric surgery pays off: a longitudinal analysis of weight loss and HbA1c changes in real-world patients data in the West of Scotland.
Leyaro B, Howie L, Ali A … +1 more , Carragher R
Int J Obes (Lond) · 2026 Mar · PMID 41258239 · Full text
RATIONALE: The long-term trajectories of weight loss and glycemic outcomes for patients who undergo bariatric surgery remain underexplored, particularly when comparing individuals who undergo surgery to those who are eli...
RATIONALE: The long-term trajectories of weight loss and glycemic outcomes for patients who undergo bariatric surgery remain underexplored, particularly when comparing individuals who undergo surgery to those who are eligible but do not proceed after referral. METHODS: This retrospective cohort study examined 411 patients with type 2 diabetes and obesity who were referred for consideration of metabolic bariatric surgery (MBS) at University Hospital Ayr, Ayrshire & Arran, between January 2009 and December 2020. The primary outcomes were change in percentage total weight loss (%TWL) and Glycosylated Hemoglobin (HbA1c) from baseline to five years. RESULTS: Of the 411 patients included, 225 (54.7%) did not undergo bariatric surgery. There were no significant differences between the surgery and non-surgery groups with respect to age, BMI or sex. 260 (63%) of the patients were female, the mean age of patients was 48.3 years (SD = 8.5), and the mean BMI was 47.4 kg/m² (SD = 7.9). At five years, patients who underwent surgery maintained a 22.0% TWL reduction compared to 8.6% in the non-surgery group (p < 0.001). HbA1c decreased by 1.0% (95% CI: -1.31, -0.70) in the surgery group but increased by 0.4% (95% CI: 0.09, 0.71) in the non-surgery group. Adjusted mixed-effects modelling showed the annual HbA1c level decreased by 0.13% (95% CI: -0.18, -0.07; p < 0.001) in the surgery group, compared to an increase of 0.11% (95% CI: 0.05, 0.17; p < 0.001) in the non-surgery group. %TWL decreased by 1.31% per year (95% CI: -1.73, -0.88; p < 0.001) in the surgery group, while the non-surgery group experienced an increase of 1.11% (95% CI: 0.66, 1.55; p < 0.001). CONCLUSION: Patients eligible for MBS who proceed with surgery achieve superior weight loss and glycaemic control compared to those who decide not to proceed with surgery. Opting out of surgery may have significant health implications, highlighting the need for alternative interventions such as intensive lifestyle modification, pharmacotherapy, and diabetes education programs for those unable or unwilling to undergo MBS.
The relationship between postural control by instrumented assessment and adiposity in children and adolescents: a systematic review.
Wilde JH, Arnold JB, Banwell HA … +2 more , Thivel D, Tsiros MD
Int J Obes (Lond) · 2026 Feb · PMID 41258238 · Publisher ↗
BACKGROUND: The impact of living with overweight or obesity on child and adolescent postural control is being increasingly researched, yet heterogenous methodology leaves the relationship unclear. OBJECTIVE: This review...
BACKGROUND: The impact of living with overweight or obesity on child and adolescent postural control is being increasingly researched, yet heterogenous methodology leaves the relationship unclear. OBJECTIVE: This review aimed to investigate associations between adiposity and instrumentally assessed postural control in children/adolescents. METHODS: The review was registered a priori with PROSPERO and reported according to PRISMA guidelines. Searches across six electronic databases were conducted from inception to November 2024, and grey literature between December 2024 to January 2025. Eligibility required analyses of an adiposity measure with instrumented postural control in otherwise healthy children and adolescents of varying weight status. The McMaster Critical appraisal tool was used, and FORM framework guided the synthesis. RESULTS: A total of 5624 database articles and seven grey literature yielded 53 eligible articles, examining a total of 8509 participants. Higher adiposity was reported to be associated with impaired postural control in 31 studies, as having no/unclear associations in 13 studies, and improved postural control in 9 studies. Participants with increased weight status consistently showed impaired postural control in more challenging assessments. The FORM overall grade of recommendation was 'C-satisfactory'. CONCLUSION: Most outcomes reported increasing adiposity to be associated with poorer postural control. Clinicians are encouraged to screen children and adolescents with excess adiposity for postural control deficits using challenging test conditions.
The prevalence of prediabetes is high and has rapidly increased, independent of the degree of obesity, in Finnish children with overweight or obesity.
Riekki H, Aitokari L, Saari A … +7 more , Kivelä L, Huhtala H, Viitasalo A, Soininen S, Haapala EA, Lakka T, Kurppa K
Int J Obes (Lond) · 2026 Feb · PMID 41254289 · Full text
OBJECTIVES: The global increase in obesity predisposes individuals to prediabetes and type 2 diabetes, but data on their prevalence, temporal trends, and associated factors in children remain limited. We examined these i...
OBJECTIVES: The global increase in obesity predisposes individuals to prediabetes and type 2 diabetes, but data on their prevalence, temporal trends, and associated factors in children remain limited. We examined these issues in well-defined patient and population cohorts. METHODS: Data were collected from 602 patients aged 6-16 years, who were examined in healthcare for overweight/obesity once in 2002-2020. Controls comprised 483 population-representative children aged 7-16, who participated in 1-3 prospective visits. Prediabetes signified fasting glucose 5.6-6.9 mmol/L or 2h-post-challenge glucose 7.8-11.0 mmol/L, and diabetes as values ≥7.0 mmol/L or ≥11.1 mmol/L, respectively. Factors associated with prediabetes in patients were studied using logistic regression. The prevalence of prediabetes was compared between patients having their first healthcare visit in different years between 2002 and 2019. RESULTS: Altogether, 89.2% of patients and 3.3-4.7% of controls had obesity. The prevalence of prediabetes was 34.2% and of type 2 diabetes 1.3% among patients, and 6.9% and 0% in controls respectively, with prediabetes increasing significantly with age and stage of puberty. Both conditions were associated with presence of metabolic dysfunction-associated steatotic liver disease (OR 1.69, 95% CI 1.01-2.80) and acanthosis nigricans (1.83, 1.05-3.21), after adjusting for age. Prevalence of prediabetes increased steeply over time from 11.4% in patients examined in 2002-2004 to 50.0% in patients examined in 2017-2019 (OR 1.16, CI 1.10-1.21 p < 0.001) without concurrent changes in the degree of obesity, body mass index, other metabolic conditions, age, sex, or gestational/neonatal factors, except for an increase in maternal prepregnancy/pregnancy overweight (20.0-68.8%, OR 1.14, CI 1.08-1.21, p < 0.001). CONCLUSIONS: Prediabetes was decidedly prevalent in pediatric patients with obesity and was associated particularly with steatotic liver disease. Its prevalence increased steeply over time, independent of the degree of obesity.
Obesity and self-rated health in middle-aged Danes.
Kristensen FPB, Madsen M, Pedersen L … +2 more , Thomsen RW, Sørensen HT
Int J Obes (Lond) · 2026 Mar · PMID 41254288 · Publisher ↗
BACKGROUND/OBJECTIVES: To examine the association between obesity and self-rated health among Danish middle-aged adults, both overall and across health-related subgroups. METHODS: This population-based cross-sectional st...
BACKGROUND/OBJECTIVES: To examine the association between obesity and self-rated health among Danish middle-aged adults, both overall and across health-related subgroups. METHODS: This population-based cross-sectional study enrolled 87,934 Danish residents aged 50-65 who completed an online questionnaire in 2021, including items on lifestyle behaviors, psychological health, and anthropometric measurements. Self-rated health was assessed using the question, "How do you find your overall health?" and categorized as "good" (combining "excellent", "very good", and "good") and "poor" (combining "less good" and "bad"). We calculated prevalences and prevalence ratios of poor health across BMI levels using Poisson regression adjusted for age, sex, and education level. RESULTS: Higher BMI levels were strongly associated with the prevalence of poor self-rated health: 10% of participants in the normal-weight group (BMI 18.5-24.9 kg/m) rated their health as poor, compared to 14% in the overweight group (25.0-29.9 kg/m), 24% in the obesity class I group (30.0-34.9 kg/m), and 39% in obesity class II group (≥35 kg/m). Compared with normal-weight participants, the prevalence ratio for poor health was 3.5 (95% CI 3.4-3.7) among those with obesity class II. The prevalence ratio attenuated in subgroups with histories of depression (1.4 [95% CI 1.3-1.5]), preexisting stress (1.3 [95% CI 1.2-1.4]), diabetes (1.6 [95% CI 1.5-1.8]), and cardiovascular disease (2.0 [95% CI 1.8-2.2]). Increased waist circumference (>102 cm for men and 88 cm for women) showed similar associations with poor self-rated health. Spline models showed a linear increasing prevalence of poor self-rated health at BMI levels above 23 kg/m and waist circumference above 90 cm in men and 85 cm in women. CONCLUSION: In middle-aged adults, a higher BMI level or increased waist circumference was strongly associated with poorer self-rated health. Obesity may indicate an unmet need for addressing health deficits beyond the effects of comorbid diseases.
Whole blood TNF-α expression and apoptotic endothelial microparticles reveal early vascular injury in pediatric obesity.
Thomazini F, Nunes MEM, de Souza PR … +3 more , Budu A, de Carvalho Araujo R, Franco MDC
Int J Obes (Lond) · 2026 Feb · PMID 41249850 · Publisher ↗
BACKGROUND: Childhood obesity is increasingly recognized as a trigger for early cardiovascular risk, partly mediated by subclinical inflammation and endothelial dysfunction. This study aimed to evaluate the expression of...
BACKGROUND: Childhood obesity is increasingly recognized as a trigger for early cardiovascular risk, partly mediated by subclinical inflammation and endothelial dysfunction. This study aimed to evaluate the expression of pro-inflammatory cytokines (TNF-α, IL-17A, and IL-2) in whole blood and investigate their associations with anthropometric measures, blood pressure, microvascular endothelial function, and circulating apoptotic endothelial microparticles (EMPs) in children with healthy weight versus those with overweight/obesity. METHODS: A cross-sectional study was conducted with 113 children aged 6-11 years, categorized as children with healthy weight (n = 82) or children with overweight/obesity (n = 31) based on BMI-for-age criteria. Endothelial function was assessed using peripheral arterial tonometry by measurement of reactive hyperemia index (RHI) and circulating apoptotic EMPs were measured by flow cytometry. Whole blood mRNA levels of inflammatory cytokines were quantified using qRT-PCR. RESULTS: Children with overweight/obesity exhibited significantly lower RHI values, indicating early endothelial dysfunction. RHI negatively correlated with BMI (r = -0.485; P < 0.001), waist circumference (r = -0.466; P < 0.001), SBP (r = -0.317, P = 0.001), DBP (r = -0.246; P = 0.009), and LDL-C levels (r = -0.191; P = 0.043). Circulating levels of apoptotic EMPs were elevated in these children and positively associated with adiposity and blood pressure, while inversely correlated with RHI (r = -0.496; P < 0.001). TNF-α expression was significantly upregulated in the overweight/obesity group and correlated positively with BMI (r = 0.468; P = 0.001), waist circumference (r = 0.492; P < 0.001), SBP (r = 0.294; P = 0.040), apoptotic EMPs (r = 0.326; P = 0.022), and negatively with RHI (r = -0.543; P < 0.001). No significant differences were observed for IL-17A or IL-2 expression. The linear regression analysis indicated that high circulating levels of both apoptotic EMPs and TNF-α mRNA were recognized as predictors factors of lower RHI value in the study population. CONCLUSION: TNF-α gene expression in whole blood and elevated levels of apoptotic endothelial microparticles are closely associated with early endothelial microvascular dysfunction in pediatric obesity. The observed associations underscore the role of inflammation-driven endothelial dysfunction in the pathophysiology of obesity-related cardiovascular risk.
Maternal monosodium glutamate exposure disrupts leptin and insulin signaling in the hypothalamus, activating NF-κB and mTOR inflammatory pathways, contributing to metabolic dysfunction in male offspring.
Hassan AH, El Nashar EM, Al-Zahrani NS … +2 more , Zafrah H, El Henafy HMA
Int J Obes (Lond) · 2026 Jan · PMID 41249849 · Publisher ↗
BACKGROUND: Maternal nutrition during critical developmental windows is increasingly recognised as a key determinant of offspring health, a concept central to the developmental origins of health and disease paradigm. Mon...
BACKGROUND: Maternal nutrition during critical developmental windows is increasingly recognised as a key determinant of offspring health, a concept central to the developmental origins of health and disease paradigm. Monosodium glutamate (MSG), a common food additive and neuroendocrine stimulant, warrants investigation in this context. METHODS: The impact of maternal MSG exposure (120 mg/kg) during gestation and/or lactation on metabolic programming in first-generation male rat offspring. Metabolic, hormonal, and molecular parameters in pups following maternal MSG administration, body weight, food intake, adiposity, glucose homeostasis (insulin sensitivity and resistance), lipid profiles, oxidative stress markers, and inflammatory mediators were measured. Furthermore, we analyzed microRNA expression profiles in relevant tissues. RESULTS: Maternal MSG exposure resulted in significant metabolic perturbations in offspring. Key findings included a reduced survival index, impaired glucose homeostasis (manifesting as decreased insulin sensitivity and increased insulin resistance), increased body weight, and elevated adiposity. We observed elevated oxidative stress, dyslipidemia, altered lipid peroxidation, and hormonal imbalances. Quantitative PCR analysis revealed altered expression of metabolic and inflammatory genes in both adipocytes and the hypothalamus. MicroRNA expression analysis identified significant alterations in miR-27a, miR-34a, miR-335, and miR-30a, suggesting potential regulatory roles in adipogenesis and metabolic control. CONCLUSIONS: Maternal MSG exposure during gestation and lactation induces profound and adverse metabolic effects in male offspring. The observed alterations in metabolic indices suggest an increased risk of metabolic disease later in life. This study underscores the critical importance of maternal nutrition during sensitive developmental periods and has implications for public health recommendations and nutritional guidelines (Graphical abstract).
Plasma metabolites may inhibit childhood obesity by regulating ferroptosis through SMPD1 and SIRT3.
Wang JG, Pan XH, Li Y
Int J Obes (Lond) · 2026 Feb · PMID 41249848 · Publisher ↗
OBJECTIVE: To investigate the causal relationship between plasma metabolites and ferroptosis-related genes in childhood obesity and to explore the potential mediating role of ferroptosis-related genes in the association...
OBJECTIVE: To investigate the causal relationship between plasma metabolites and ferroptosis-related genes in childhood obesity and to explore the potential mediating role of ferroptosis-related genes in the association between plasma metabolites and childhood obesity risk. METHODS: A bidirectional two-step Mendelian randomization (MR) approach was applied, leveraging publicly available genome-wide association study (GWAS) datasets to analyze the causal relationship among 1400 plasma metabolites, 159 ferroptosis-related genes, and childhood obesity. In the first step, protein quantitative trait loci (pQTL) data corresponding to ferroptosis-related genes were identified as mediators to evaluate the causal effects of plasma metabolites and ferroptosis-related genes on childhood obesity. In the second step, MR analysis was conducted on ferroptosis-related genes and plasma metabolites identified in the first step to confirm their causal association. The inverse-variance weighted (IVW) method was primarily used for meta-analysis, while MR-PRESSO was employed to detect pleiotropy and outliers. RESULTS: Four ferroptosis-related genes (SMPD1 and SIRT3 suppressing obesity, GSTZ1 and ADAMTS13 promoting obesity) and nine plasma metabolites were found to be significantly associated with childhood obesity (six negatively correlated and three positively correlated). Further mediation analysis indicated that the ferroptosis mechanism regulated by SMPD1 and SIRT3 partially mediated the association between specific plasma metabolites and childhood obesity, with the highest mediation proportion reaching 9.62%. Sensitivity analysis confirmed the robustness of the results (no heterogeneity or horizontal pleiotropy), and reverse Mendelian randomization ruled out causal interference. CONCLUSION: This study is the first to reveal, through Mendelian randomization analysis, the potential mediating role of ferroptosis-related genes in the association between plasma metabolites and childhood obesity. It suggests that the ferroptosis mechanism may influence childhood obesity risk by regulating specific metabolites. These findings contribute to understanding the role of ferroptosis in the pathological mechanisms of childhood obesity and provide novel molecular targets and intervention strategies for obesity prevention and treatment in children.
The Physiology Of the WEight Reduced State (POWERS) study: assessing energy balance.
Rosenbaum M, Allison KC, Laughlin MR … +11 more , Whyte K, Jakicic JM, Mayer LES, Ashby-Thompson M, Hayes MR, Speakman J, Leibel RL, Das SK, Gallagher D, Roberts SB, POWERS Consortium
Int J Obes (Lond) · 2025 Nov · PMID 41249847 · Full text
BACKGROUND/OBJECTIVES: We provide the rationale for and description of energy balance measures (i.e., energy intake and energy expenditure) in The Physiology Of the WEight Reduced State (POWERS) study which aims to under...
BACKGROUND/OBJECTIVES: We provide the rationale for and description of energy balance measures (i.e., energy intake and energy expenditure) in The Physiology Of the WEight Reduced State (POWERS) study which aims to understand the contribution of the many factors that influence weight regain following behavioral weight loss. METHODS: The primary dependent variable is weight regain over 1 year following a 7% or greater supervised weight loss. The balance between energy intake and expenditure is the primary determinant of weight regain. Healthy adults (target n = 205), aged 25- < 60 years, with body mass index (BMI) 30- < 40 kg/m are being recruited. Energy intake and expenditure phenotypes are measured prior to weight loss (baseline, BL), immediately following weight loss (T0), and then four (T4) and 12 months (T12) after weight loss. Weight stability is required before BL and T0 measurement periods. Weight change at T12 from T0 is the primary outcome variable. Energy intake is measured with serial doubly labeled water (DLW) measurements combined with dual x-ray absorptiometry (DXA) to assess changes in fat and lean mass; DLW is also used to measure twenty-four-hour energy expenditure (TEE). Components of TEE including resting energy expenditure (REE) and non-resting and activity energy expenditure (NREE and AEE), as well as skeletal muscle chemomechanical efficiency and grip strength are assessed. Self-reported dietary intake is assessed with interviewer-administered multiple-pass 24-hour food recalls. DISCUSSION: This manuscript describes the rationale for the methods chosen to assess energy balance and the analytical methods employed to normalize and express data in the setting of changes in body weight and composition immediately following behavioral weight loss and thereafter at 4- and 12-months post-weight loss.
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