International Journal Of Obesity (2005)[JOURNAL]
Sun
200 papers
Metabolically healthy obesity is independently associated with 20-year incidence of cardiovascular disease: findings from the ATTICA cohort study (2002-2022).
Filippatos TD, Katrapas P, Tsiampalis T … +8 more , Chrysohoou C, Barkas F, Liberopoulos E, Sfikakis PP, Tsioufis C, Pitsavos C, Panagiotakos D, ATTICA study group
Int J Obes (Lond) · 2026 Jun · PMID 42000928 · Full text
BACKGROUND: Individuals with excess body weight do not share the same risk for cardiovascular disease (CVD). The phenotype of metabolically healthy obesity (MHO) has drawn the attention of the scientific community due to...
BACKGROUND: Individuals with excess body weight do not share the same risk for cardiovascular disease (CVD). The phenotype of metabolically healthy obesity (MHO) has drawn the attention of the scientific community due to a potentially reduced CVD risk compared with the phenotype of metabolically unhealthy obesity (MUO). METHODS: A prospective cohort study was conducted involving 3042 participants from the Attica region in Greece. Baseline demographic, clinical, and lifestyle characteristics were assessed, with participants categorized by their obesity and metabolic health status. Cox proportional hazards models were used to analyze the association between obesity/metabolic health status and 20-year CVD incidence, adjusting for relevant covariates. RESULTS: The sample at baseline comprised 38% individuals who were metabolically healthy without obesity (MHWO), 44% individuals who were metabolically unhealthy without obesity (MUWO), 6% individuals with MHO, and 12% individuals with MUO. Over the 20-year follow-up, 718 participants experienced a CVD event; participants with MUO demonstrated the highest incidence rate (61.1%). Cox regression analyses revealed that individuals with MUO had an 85% higher risk of developing CVD compared with individuals having the MHWO phenotype (HR = 1.85, 95% CI = 1.02-3.58). Individuals with MHO had a 39% elevated risk compared with individuals having the MHWO phenotype (HR = 1.39, 95% CI = 1.06-3.42). Groups with MHO and MUO had independently increased CVD risk, even after multivariable adjustment. CONCLUSIONS: Individuals with MUO exhibit the highest risk, but individuals with MHO also have an independently increased CVD risk, emphasizing the significant impact of both obesity and metabolic health status on long-term CVD incidence.
Childhood adversity and gestational diabetes: examining the mediating effect of BMI and depression through interventional mediation analysis.
Davies M, De Stavola B, Nielsen KK … +2 more , Damm P, Rod NH
Int J Obes (Lond) · 2026 Apr · PMID 41991676 · Publisher ↗
BACKGROUND: Childhood adversity has been shown to increase the risk of gestational diabetes mellitus (GDM), though the mechanisms through which the risk is increased have yet to be examined. METHODS: We used register dat...
BACKGROUND: Childhood adversity has been shown to increase the risk of gestational diabetes mellitus (GDM), though the mechanisms through which the risk is increased have yet to be examined. METHODS: We used register data on all women born in Denmark and giving birth for the first time between 2004 and 2018, totalling 207,659 women. Interventional mediation analysis was used to estimate how two mechanistic pathways, depression and pre-pregnancy BMI, mediate the relationship between childhood adversity and GDM across five previously identified adversity trajectory groups. RESULTS: 4779 women were diagnosed with GDM between 2004 and 2018, corresponding to a 2.3% absolute risk of GDM. Compared to those who experienced low adversity in childhood, we estimated that those who experienced early material deprivation could have a 0.12% [95% CI 0.10, 0.14] reduction in absolute GDM risk by intervening on BMI and equalising its distribution to that of mothers in the low adversity group. We found no evidence of a reduction in risk if depression were similarly intervened on. For those in the high levels of adversity group no evidence of mediation was found. CONCLUSIONS: Intervening on pre-pregnancy BMI might potentially reduce the risk of GDM for mothers in some of the adversity groups, whereas intervening on depression seems to have little impact. The findings suggest that high adversity likely increases the risk of GDM through alternative mechanisms than BMI or depression.
Association of cord blood mitochondrial DNA heteroplasmy and copy number with childhood overweight or obesity.
Qu X, Wang G, Hong X … +3 more , An J, Vernon HJ, Wang X
Int J Obes (Lond) · 2026 Apr · PMID 41981288 · Full text
BACKGROUND: Mitochondria, the cell's powerhouse, play a central role in energy homeostasis and may influence obesity risk. Variations in mitochondrial DNA (mtDNA) have been hypothesized to influence early-life metabolic...
BACKGROUND: Mitochondria, the cell's powerhouse, play a central role in energy homeostasis and may influence obesity risk. Variations in mitochondrial DNA (mtDNA) have been hypothesized to influence early-life metabolic programming; however, prospective evidence remains limited, and no study has jointly examined multiple mtDNA biomarkers. We aimed to investigate the individual and combined associations of cord blood mtDNA heteroplasmy and copy number with the risk of childhood overweight or obesity (OWO). METHODS: Data were obtained from 952 children enrolled at birth and followed longitudinally in the Boston Birth Cohort. Body mass index (BMI) z scores were calculated using U.S. reference data, and OWO was defined as BMI ≥85th percentile for age and sex. Cord blood mtDNA heteroplasmy and copy number were assessed by targeted sequencing, with functional region heteroplasmy defined as heteroplasmic variants in coding regions and classified as inherited or de novo. Mixed-effects models were used to evaluate associations between mtDNA measures and repeated measures of child BMI and OWO. RESULTS: In sex-specific analyses, de novo functional region heteroplasmy was associated with higher BMI z score (β = 0.29, 95% CI: 0.01, 0.57) and increased risk of OWO (RR = 1.46, 95% CI: 1.07, 2.00) among girls, whereas no associations were observed overall. BMI associations were more evident in adolescent girls (aged 10-18 years). MtDNA copy number z score was negatively associated with BMI in children with overall or de novo functional region heteroplasmy but showed modest positive associations in those without specific heteroplasmy (p for interaction < 0.05). CONCLUSIONS: Cord blood mtDNA heteroplasmy and copy number interactively influence the risk of childhood OWO, with associations varying by sex and age. This is the first prospective study to jointly evaluate these mtDNA biomarkers, offering new insight into mitochondrial contributions to the developmental origins of OWO and a potential framework for early-life risk assessment.
The association of prenatal adiposity characteristics with early childhood overweight and obesity: findings from a large and diverse mother-child cohort.
Min H, Bloom MS, Lawrence GN … +2 more , Fuller A, Huddleston KC
Int J Obes (Lond) · 2026 Apr · PMID 41981287 · Publisher ↗
BACKGROUND: Maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) are risk factors for overweight and obesity (OWO) in childhood. However, a better understanding of the magnitude, timing, and me...
BACKGROUND: Maternal prepregnancy body mass index (ppBMI) and gestational weight gain (GWG) are risk factors for overweight and obesity (OWO) in childhood. However, a better understanding of the magnitude, timing, and mediating mechanisms of these associations can inform interventions to improve maternal and child health. METHODS: We conducted a prospective cohort study of 2899 mother-child dyads in northern Virginia (2012-2019). Maternal ppBMI was self-reported and GWG was calculated and categorized as excess (EGWG) using 2009 Institute of Medicine guidelines. Child weight was reported by parents every six months from birth to 24 months, and annually thereafter. Childhood OWO was defined as >85th percentile of WHO growth charts at 36 months. Generalized linear and mixed models estimated maternal OWO status and GWG as predictors of children's body weight Z-score and growth velocity, adjusted for covariate. Causal mediation analysis was used to quantify birth weight and early growth velocity as intervening factors. RESULTS: Mothers self-reported Hispanic (32.08%) and non-Hispanic (51.98%) ethnicity (15.94% missing). Mean ± SD ppBMI was 25.5 ± 5.4 kg/m² (35.46% with obesity) and GWG was 14.2 ± 6.8 kg (40.8% EGWG). At 36 months, 25.4% of children had overweight and 10.5% had obesity. Higher ppBMI (RR = 1.04 per 1.00 kg/m; 95% CI: 1.03-1.06) and GWG was associated with childhood risk of OWO among non-Hispanic but not Hispanic mothers (interaction P = 0.02). Similarly, maternal obesity status (RR = 1.64; 95% CI: 1.26-2.13) and EGWG (RR = 1.38; 95% CI: 1.09-1.74) were associated with childhood OWO risk. Approximately 26.8% (95% CI: 14.9%-55.9%) of the ppBMI-OWO association could be attributed to birth weight. CONCLUSIONS: Maternal ppBMI and GWG were independently associated with risk of OWO in early childhood OWO, with variations by child age and ethnicity, highlighting the potential of pre- and perinatal interventions to reduce childhood obesity risk.
Racial and ethnic variations of metabolic indicators associated with childhood obesity: a comparative cross-sectional study.
Wu J, Xu Z, Xi L … +3 more , Zhang M, Li X, Luo F
Int J Obes (Lond) · 2026 Jun · PMID 41957116 · Publisher ↗
BACKGROUND: Susceptibility to adult metabolic diseases varies significantly across ethnicities. Asian adults exhibit elevated risks associated with obesity at lower body mass index (BMI) levels; whether similar patterns...
BACKGROUND: Susceptibility to adult metabolic diseases varies significantly across ethnicities. Asian adults exhibit elevated risks associated with obesity at lower body mass index (BMI) levels; whether similar patterns occur in pediatric populations remains unclear. This study aimed to evaluate how metabolic indicators associated with childhood obesity vary across diverse racial/ethnic groups. METHODS: Age-matched adolescents (12-18 years) from diverse regions across China-along with adolescents from Hispanic, Mexican American (MA), Non-Hispanic Black (NHB), Non-Hispanic White (NHW), and Other ethnic groups from the National Health and Nutrition Examination Survey (NHANES)-were enrolled. Comprehensive demographic, anthropometric and metabolic data-including glycemic parameters, lipid profiles, and insulin resistance indices-were analyzed. Cross-sectional mediation analysis was conducted to explore the potential biological pathways underlying the relationship between obesity (BMI standard deviation score [SDS] as the exposure) and metabolic dysfunction (metabolic indicators as the outcomes), testing cortisol and adrenocorticotropic hormone (ACTH) as potential mediators. Average direct and causal mediation effects were evaluated, with results interpreted as statistical associations consistent with the mediation framework. RESULTS: The study included 632 adolescents (55.22% male, mean age 14.51 ± 1.87 years, median BMI 31.55 kg/m). Compared to Chinese adolescents, NHB had higher HbA1c, NHW had lower HbA1c; both showed lower HOMA-β. All groups had higher HDL-C, lower total cholesterol and LDL-C levels than Chinese adolescents. HbA1c correlated positively with BMI SDS in Chinese and MA adolescents. Fasting insulin and HOMA-IR correlated positively with BMI SDS in all groups except Hispanic adolescents, while HOMA-β correlated positively in all groups except Hispanic and NHW adolescents. In Chinese adolescents, ACTH mediated the associations of BMI SDS with fasting insulin and HOMA-IR (P = 0.014 and 0.020 for mediation effects, respectively). CONCLUSIONS: This first multiethnic pediatric metabolic comparison reveals distinct racial/ethnic patterns, with ACTH emerging as a novel mediator in Chinese adolescents. Findings underscore the need for ethnicity-tailored prevention strategies.
Assessing the effectiveness of healthy weight interventions in the early years of childhood: a systematic review and meta-analysis of evidence from high-income countries.
Dhar D, Karwatowska L, Sifaki M … +4 more , Michalopoulou S, Stansfield C, Packer J, Russell SJ
Int J Obes (Lond) · 2026 Jun · PMID 41957115 · Full text
BACKGROUND: Early childhood represents an important opportunity for establishing lifelong health behaviours, including the maintenance of a healthy weight. Given that weight patterns established in early life often persi...
BACKGROUND: Early childhood represents an important opportunity for establishing lifelong health behaviours, including the maintenance of a healthy weight. Given that weight patterns established in early life often persist into adolescence and adulthood, there is an urgent need to understand whether universal interventions in early childhood are effective in preventing excess weight gain. We aimed to systematically synthesise the effects of universal healthy weight interventions for pre-school children on anthropometric outcomes. METHODS: We searched nine academic databases and included studies published from 2011 with pre-post implementation assessments of anthropometric outcomes amongst preschool children aged 5 years and under. Eligible studies included interventions that incorporated diet, physical activity, and/or behavioural change components. All studies were included in a narrative synthesis and, where possible, three-level random-effects meta-analyses were conducted to pool standardised mean differences. RESULTS: A total of 40 studies (n = 26,977 participants) met the inclusion criteria. The most commonly reported outcomes were BMI z-score (zBMI; k [number of studies] = 27), weight status categories (k = 19), BMI (k = 14), BMI percentiles (k = 11), body weight (k = 8), waist circumference (k = 8), skinfolds (k = 6), percentage body fat (k = 3), fat-free mass index (k = 3), and fat mass index (k = 2). The findings from the meta-analyses suggested that children receiving interventions had significantly lower zBMI (SMD [standardised mean difference] = -0.085, 95% CI -0.140, -0.029), lower waist circumference (SMD = -0.186, 95% CI -0.361, -0.011), percentage body fat (SMD = -0.159, 95% CI -0.290, -0.028) and higher fat-free mass index (SMD = 0.170, 95% CI 0.012, 0.328) compared to controls. No significant differences were found for BMI percentile. Narrative synthesis indicated limited evidence of effectiveness. CONCLUSIONS: Universal multicomponent healthy weight interventions for preschool children in high-income countries were associated with modest but meaningful improvements in zBMI, waist circumference, percentage body fat, and fat-free mass index. These findings suggest that early childhood interventions can be effective if delivered at scale and may serve as a key element in broader childhood obesity prevention strategies.
Real-world outcomes of hybrid obesity care using digital coaching and GLP-1 therapy in a multi-ethnic Asian setting.
Ali SH, Lee MH, Tan KXQ … +4 more , Wong CJ, Magkos F, Ang IYH, Toh SA
Int J Obes (Lond) · 2026 Jun · PMID 41957114 · Full text
BACKGROUND: Obesity remains a major health challenge globally and in Asia, driving cardio-metabolic disease risks. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and mobile health (mHealth) coaching each demonstra...
BACKGROUND: Obesity remains a major health challenge globally and in Asia, driving cardio-metabolic disease risks. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and mobile health (mHealth) coaching each demonstrate weight loss efficacy, but real-world evidence for hybrid models combining these treatments remains limited, especially in multi-ethnic Asian settings. METHODS: We evaluated real-world outcomes among 708 adults enrolled in NOVI Optimum Plus, a physician-led obesity program in Singapore that integrates GLP-1 RA pharmacotherapy with app-based lifestyle coaching. Data on weight, metabolic indicators, and engagement were extracted from clinical records and the mHealth platform. Linear mixed models estimated changes over 6-18 months, stratified by engagement, metabolic status, and ethnicity. RESULTS: Participants (mean age 42.1 years; 64.1% female) were primarily East Asian (45.5%), European (26.8%), South Asian (13.3%), and Southeast Asian (10.3%). Most received semaglutide (86% oral 14 mg). At 12 months, mean weight loss was 12.7% (95% CI: -14.0, -11.3) and BMI dropped by 4.1 points, with further weight loss reaching 14.7% at 18 months. Systolic blood pressure decreased by 11.5 mmHg, body fat percentage by 8.8%, waist-to-hip ratio improved from 0.83 to 0.80, and HbA1c declined by 0.6%. Greater app engagement was linked to 2.0-2.2% additional weight loss, 0.72 kg/m² more BMI reduction, and up to 2.9 mmHg greater systolic BP drop. More frequent health coach contact contributed modest added improvements for weight and BMI. Weight loss was significantly lower among East Asians and those with hyperglycemia. CONCLUSION: In this real-world Asian setting, hybrid obesity care combining GLP-1 RAs with digital coaching produced clinically meaningful, sustained weight and metabolic improvements. Higher engagement consistently enhanced outcomes, supporting scalable integrated models tailored for diverse populations.
Reproductive hormone stability with prolonged intranasal oxytocin in adults with obesity.
Galbiati F, Hiranandani S, Wronski ML … +11 more , Plessow F, Holman K, Asanza E, Smith SE, Muhammed M, Golden ER, Hadaway N, Getachew E, Misra M, Aulinas A, Lawson EA
Int J Obes (Lond) · 2026 Apr · PMID 41951782 · Full text
CONTEXT: Oxytocin, a posterior pituitary hormone known for its role in parturition and lactation, is also implicated in many physiologic functions. Intranasal oxytocin is under investigation for obesity treatment, among...
CONTEXT: Oxytocin, a posterior pituitary hormone known for its role in parturition and lactation, is also implicated in many physiologic functions. Intranasal oxytocin is under investigation for obesity treatment, among other indications. The interplay of anterior and posterior pituitary hormones is currently not well understood. Given the well-established role of oxytocin in reproduction, it is important to examine intranasal oxytocin effects on prolactin and the hypothalamic-pituitary-gonadal (HPG) axis. Preclinical studies indicate that regulation of oxytocin, prolactin, and sex steroids in both sexes are intertwined; however, data in humans are limited, and no studies have reported the effects of prolonged oxytocin administration on prolactin or the HPG axis OBJECTIVE: To elucidate physiology and generate preliminary data regarding reproductive safety of prolonged intranasal oxytocin, we leveraged a completed trial to investigate oxytocin effects on circulating prolactin and sex steroid levels in adults with obesity. METHODS: Sixty-one adults with obesity (52% females) participated in a longitudinal randomized clinical trial data and received eight-weeks intranasal oxytocin (24 IU) four times daily or placebo. Main outcome measures were pre- and post-treatment fasting estradiol, testosterone, and prolactin; exploratory outcome measure was on-treatment menstrual cycle length. RESULTS: Oxytocin vs. placebo groups did not differ for effects on prolactin or sex steroid levels (p's ≥ 0.140). On-treatment mean menstrual cycle length did not differ across groups (p = 0.234). CONCLUSION: In our study, eight-weeks of intranasal oxytocin administration did not impact prolactin or sex steroid levels, or menstrual cycle length, providing preliminary support for reproductive safety of oxytocin-based therapeutics in adults with obesity.
Racial and ethnic disparities in type 2 diabetes: does visceral fat play a role? Evidence from the MESA study.
Xia T, Nianogo RA, Yu Q … +8 more , Horwich T, Srikanthan P, Inoue K, Allison M, Zhang ZF, Szklo M, Watson KE, Chen L
Int J Obes (Lond) · 2026 Jun · PMID 41951781 · Full text
OBJECTIVE: In the United States, racial and ethnic minorities have higher risk of developing type 2 diabetes (T2D) than Whites. One hypothesis is that some minorities (e.g., Hispanics, Asians) have more visceral fat than...
OBJECTIVE: In the United States, racial and ethnic minorities have higher risk of developing type 2 diabetes (T2D) than Whites. One hypothesis is that some minorities (e.g., Hispanics, Asians) have more visceral fat than Whites in a sex-specific manner. We aimed to test this hypothesis by examining to what degree racial differences in T2D were explained by visceral fat in males and females. METHODS: This prospective cohort included 1457 participants (51.2% females) from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort who had visceral fat measured by computed tomography and followed for incident T2D from 2002-2005 to 2020. We assessed associations of race and T2D risk using Cox proportional hazards regressions and estimated associations explained by visceral fat using natural mediation effects, stratified by sex. RESULTS: Controlling for confounders, compared with White participants, T2D risk was higher in Hispanic females (HR 1.77, 95% CI 1.17-2.69), Chinese females (1.91, 1.15-3.15), Black females (1.59, 1.02-2.49), and Hispanic males (1.82, 1.20-2.76). Estimates for Black males (1.48, 0.92-2.38) and Chinese males (0.86, 0.48-1.55) were not statistically significant. By sex, Hispanic females [mean difference (SE): 22.72 (5.68)] had higher visceral fat (cm) than White females, while Chinese [-77.56 (8.47)] and Black [-57.57 (8.11)] males had lower visceral fat (cm) than White males. Visceral fat explained 23.1% of T2D risk between Hispanic and White females, but not for other racial and sex subgroups. CONCLUSION: Visceral fat explained one-fifth of racial and ethnic differences in T2D comparing Hispanic females to White females and may contribute to Hispanic females' higher T2D risk.
Longitudinal associations between BMI changes and musculoskeletal pain in older European males and females.
Brown AA, Lykkegaard J, Thorlund JB … +3 more , Möller S, Søndergaard J, Ahrenfeldt LJ
Int J Obes (Lond) · 2026 Apr · PMID 41951780 · Publisher ↗
BACKGROUND: Musculoskeletal pain affects nearly 200 million European citizens and is a leading cause of disability. This study examines the associations between body mass index (BMI) trajectories over time and self-repor...
BACKGROUND: Musculoskeletal pain affects nearly 200 million European citizens and is a leading cause of disability. This study examines the associations between body mass index (BMI) trajectories over time and self-reported musculoskeletal pain, and explores how these associations differ by sex. METHODS: We conducted a longitudinal cohort study using data from waves 5-9 (2013-2022) of the Survey of Health, Ageing and Retirement in Europe. A total of 73,469 participants (mean age 70 years; 56% female) contributed at least two BMI measurements across study waves. Baseline and follow-up BMI values were categorized into sex-stratified quartiles, resulting in 16 distinct BMI trajectories. Associations between these trajectories and incident back, hip, knee, and other joint pain were examined using mixed-effects logistic regression models, adjusted for age, region, education, income, household partnership, comorbidities, and smoking. Stable low BMI served as the reference group. RESULTS: Compared with stable low BMI trajectory, both upward and downward BMI trajectories, as well as stable high BMI, were associated with increased odds of musculoskeletal pain, with the strongest associations observed for stable high BMI. Stable high or changing BMI showed consistent associations with incident back, hip, and knee pain, while associations with other joint pain were weaker and less consistent. Overall, the associations were stronger for females than for males, but sex differences were most pronounced for hip and knee pain. Notably, maintaining a stable high BMI was associated with one of the highest odds of incident knee pain in females (odds ratio = 4.17, CI = 3.33-5.23). CONCLUSIONS: Elevated BMI at any time point was associated with increased odds of musculoskeletal pain, even among individuals who lost weight. The findings suggest that the cumulative duration of exposure to high BMI may be a critical factor in the development and prevention of musculoskeletal pain.
Beyond the Surface: Mechanistic Intersections Between Obesity and UVB Exposure.
Sheikh UA, Sheikh TA
Int J Obes (Lond) · 2026 Apr · PMID 41951779 · Publisher ↗
Obesity, a globally prevalent metabolic disorder, and ultraviolet-B (UVB) radiation, an inherent component of solar exposure, are each independently linked to a wide range of chronic health outcomes, including cancer, me...
Obesity, a globally prevalent metabolic disorder, and ultraviolet-B (UVB) radiation, an inherent component of solar exposure, are each independently linked to a wide range of chronic health outcomes, including cancer, metabolic dysfunction, and immune dysregulation. Although traditionally viewed as separate risk factors, metabolic and environmental, respectively, emerging evidence reveals mechanistic intersections that may amplify disease burden when both are present. Obesity promotes chronic low-grade inflammation, oxidative stress, adipokine imbalance, and impaired DNA repair capacity, while UVB radiation induces mutagenic photoproducts, reactive oxygen species, and localized immunosuppression. These overlapping pathways converge on genomic instability, altered immune tolerance, and the development of tumor-promoting microenvironments, particularly within the skin. This review synthesizes recent advances in understanding the biological mechanisms linking obesity and UVB exposure, with emphasis on synergistic effects on oxidative stress, nucleotide excision repair efficiency, and immune surveillance. It examines experimental and clinical evidence supporting these interactions and highlights emerging therapeutic strategies, including phototherapy and vitamin D modulation, clarifying their mechanistic rationale in restoring immune balance and enhancing DNA repair. Finally, the review discusses implications for integrated prevention, risk stratification, and public health policy. By framing obesity and UVB radiation as a compound risk factor, this article underscores the need for interdisciplinary approaches to mitigate their combined impact on global health. Converging Effects of Obesity and UVB Exposure on Skin Carcinogenesis: Obesity and UVB exposure converge through shared inflammatory, oxidative, and immune-modulating pathways that amplify skin cancer risk. Obesity drives chronic inflammation, oxidative stress, altered adipokine signaling, and impaired DNA repair, while UVB radiation causes direct DNA damage, reactive oxygen species, and local immunosuppression. Together, these stressors synergistically intensify oxidative injury, weaken DNA damage responses, and diminish immune surveillance, promoting the development of basal and squamous cell carcinoma. Emerging therapeutic approaches including vitamin D modulation, UVB-based phototherapy, and autophagy-targeted interventions, highlight opportunities for prevention and clinical translation.
Non-invasive islet β-cell markers track with weight-loss interventions for type 2 diabetes: a prospective cohort study.
Sun H, Shen Y, Burke SJ … +6 more , Brantley P, Brock R, Zhang D, Yang S, Hu G, Collier JJ
Int J Obes (Lond) · 2026 Jun · PMID 41951778 · Full text
OBJECTIVE: This study investigated the longitudinal impact of intensive medical intervention (IMI) and bariatric surgery procedures on indirect measures of pancreatic β-cell death and function. METHODS: Eighty-four parti...
OBJECTIVE: This study investigated the longitudinal impact of intensive medical intervention (IMI) and bariatric surgery procedures on indirect measures of pancreatic β-cell death and function. METHODS: Eighty-four participants (28 non-type 2 diabetes [T2D], 56 T2D) from the HEADS UP study were assessed at baseline and 1-year post-intervention. Circulating unmethylated and methylated insulin gene [INS] DNA were quantified from blood samples via droplet digital polymerase chain reaction (PCR). Metabolic biomarkers, including fasting plasma glucose, HbA1c, proinsulin-to-insulin ratio, insulin, and C-peptide, were analyzed. RESULTS: At baseline, participants with T2D had significantly higher levels of unmethylated INS DNA and higher unmethylated-to-methylated INS DNA ratios than individuals without T2D. After 1-year, significant reductions in these biomarkers were observed primarily in the T2D group. Bariatric surgeries yielded greater improvements in metabolic profiles and reductions in unmethylated INS DNA than IMI. Despite substantial metabolic improvement, participants with T2D maintained elevated proinsulin-to-insulin ratios, indicating alterations to β-cell function. CONCLUSIONS: Circulating unmethylated INS DNA is a non-invasive index of β-cell death and responds to weight-loss interventions. Metabolic surgeries are more effective than IMI in preserving β-cell mass and function, highlighting their potential in diabetes management. Long-term studies are necessary to confirm these initial findings.
Risk factors and clinical nomogram for fatty pancreas in adults with obesity: a case-control study.
Pang C, Gao X, Fan Z … +10 more , Gao C, Liu S, Meng Y, Diao B, Wang R, Liu Z, Huang X, Zhu T, Liu S, Zhan H
Int J Obes (Lond) · 2026 Apr · PMID 41946902 · Publisher ↗
OBJECTIVES: The correlation between fatty pancreas (FP) and metabolic-associated steatotic liver disease (MASLD), diabetes and other metabolic diseases is still controversial, and it is crucial to recognize the risk fact...
OBJECTIVES: The correlation between fatty pancreas (FP) and metabolic-associated steatotic liver disease (MASLD), diabetes and other metabolic diseases is still controversial, and it is crucial to recognize the risk factors of FP to prevent its clinical complications. METHODS: Retrospective collection of clinical, pathologic, and imaging data of people with obesity attending Qilu Hospital of Shandong University from January 1, 2020 to October 1, 2022. FP was diagnosed by non-enhanced computed tomography with the ratio of pancreas/spleen <0.7. Using binary logistics regression analysis to construct an FP prediction nomogram model, bootstrap repeated sampling internal validation and temporal external validation were used to test the predictive performance of the model. RESULTS: In this cohort, the average age of the participants was 32.2 years, and the average BMI was 41.3 Kg/m. The prevalence of FP 23.3% (144/617). People with obesity with or without comorbid FP have partial differences in blood glucose, lipid. Independent factors for FP were body mass index (BMI) (OR = 1.97, 95% CI 1.29-3.01; P = 0.002), diastolic blood pressure (DBP) (OR = 1.55, 95% CI 1.03-2.33; P = 0.035), high-density lipoprotein (HDL) (OR = 1.67, 95% CI 1.11-2.52; P = 0.014), HbA1C (OR = 1.99, 95% CI 1.19-3.34; P = 0.009). This study constructed a nomogram containing these four indicators for FP, and receiver operating characteristic curve analysis indicated that the nomogram has moderate predictive performance. CONCLUSIONS: This study identified key risk factors and developed a validated prediction nomogram for FP in adults with obesity. This model may facilitate early identification of FP and the prevention of related metabolic disorders.
Movement behaviors, psychosocial well-being and childhood obesity: the IDEFICS/I.Family cohort.
Masip G, Møller Jørgensen R, Veidebaum T … +9 more , Molnar D, Lissner L, Lauria F, De Henauw S, Hadjigeorgiou C, Hebestreit A, Buck C, Ahrens W, Moreno LA
Int J Obes (Lond) · 2026 Apr · PMID 41942743 · Publisher ↗
BACKGROUND: Understanding the association between movement behaviors and psychosocial well-being at a young age seems essential for effective interventions and moving friendly environments, particularly in the context of...
BACKGROUND: Understanding the association between movement behaviors and psychosocial well-being at a young age seems essential for effective interventions and moving friendly environments, particularly in the context of childhood obesity. OBJECTIVES: to examine the association between adherence to movement behavior guidelines and psychosocial well-being, and whether obesity indices moderate this association. METHODS: The IDEFICS/IFamily cohort followed European children aged 2-16 years over 6 years, including 7359 repeated observations across three waves. Longitudinal associations between adherence to movement behavior recommendations and psychological well-being were assessed using generalized linear models. Obesity indicators, z-score body mass index (z-BMI) and z-score waist circumference (z-BMI) were used to test their moderating role. RESULTS: Lower adherence to movement behaviors was negatively associated with psychosocial well-being (β = -0.39, 95%CI: -0.77, 0.00), with stronger effects in males (β = -0.70, 95%CI: -1.20, -0.20). Moreover, effects were larger in participants with overweight/obesity (β = -1.29, 95%CI: -2.21, -0.37). Obesity indices moderated the association between movement behaviors and psychosocial well-being (β = -0.40, 95%CI: -0.80, -0.06 for z-BMI; β = -0.36, 95%CI: -0.82, -0.03 for z-WC). CONCLUSIONS: Adherence to movement behavior guidelines was associated with psychosocial well-being, especially in males and individuals with overweight or obesity. These findings highlight the potential relevance of movement behavior patterns for psychosocial well-being and obesity prevention, while acknowledging the observational nature of the data.
The effect of weight-loss surgery in patients with obesity on adipose tissue mesenchymal stem cells versus circulating endothelial progenitor cells.
Yang N, Al Saeedi MH, Xue A … +8 more , Hamidabad NM, Zhu X, Tang H, Jordan KL, Kukla A, Eirin A, Lerman A, Lerman LO
Int J Obes (Lond) · 2026 Apr · PMID 41942742 · Publisher ↗
BACKGROUND/OBJECTIVE: Obesity imposes dysfunction of the endogenous cellular reparative system, which may manifest as impaired adipose tissue-derived mesenchymal stem/stromal cells (AT-MSCs) function or altered character...
BACKGROUND/OBJECTIVE: Obesity imposes dysfunction of the endogenous cellular reparative system, which may manifest as impaired adipose tissue-derived mesenchymal stem/stromal cells (AT-MSCs) function or altered characteristics of circulating endothelial progenitor cells (EPCs). However, whether both systems are abnormal in patients with obesity remains unclear. We hypothesized that human obesity induces impairment of MSCs and EPCs that would be reversed after weight-loss surgery (WLS). METHODS: Abdominal adipose tissue and peripheral blood mononuclear cells were collected to harvest MSCs and EPCs, respectively, from patients with obesity (n = 8) before and 9-12 months after WLS. MSCs mitochondrial function and EPCs number and surface markers were compared to those collected from healthy controls (HC). RESULTS: Patients with obesity had a higher basal body mass index compared to both HC (P < 0.0001) and post-WLS (P < 0.001). Compared to HC, MSC proliferative and differentiation capacity was preserved (P > 0.05), but they showed at baseline increased mitochondrial oxidative stress, and cytochrome-c release (P < 0.05), with reduced membrane potential and matrix density, which mostly improved after WLS. The percent of circulating CD34KDRCD133 and CD34KDR EPCs was elevated in patients with obesity (P < 0.05), as were EPC fractions expressing the inflammatory marker VAP-1 or pro-calcinogenic marker OCN-1, yet neither fell after WLS (P > 0.05). CONCLUSION: Obesity impairs MSC mitochondrial function and increases the percent of circulating, but also potentially injurious EPCs. WLS largely reverses MSC mitochondrial injury and but not circulating EPC characteristics. Therefore, restoration of the endogenous tissue-resident and circulating cellular regenerative systems in the same patients with obesity may require different strategies or timeframes.
Cold-induced metabolic flexibility explains ethnic disparities among individuals with obesity and insulin resistance.
Sun L, Goh HJ, Bi X … +2 more , Chan SP, Leow MK
Int J Obes (Lond) · 2026 Jun · PMID 41942741 · Publisher ↗
BACKGROUND: Cold-induced thermogenesis (CIT) mediated by brown adipose tissue (BAT) and skeletal muscle holds therapeutic utility for obesity, but relative tissue contribution to CIT-driven metabolic flexibility (MetF) a...
BACKGROUND: Cold-induced thermogenesis (CIT) mediated by brown adipose tissue (BAT) and skeletal muscle holds therapeutic utility for obesity, but relative tissue contribution to CIT-driven metabolic flexibility (MetF) and its correlation to insulin resistance remain undefined across diverse ethnicities. OBJECTIVE: This study aimed to investigate ethnic differences in cold-induced MetF and its link to insulin sensitivity in Chinese and Asian Indian individuals with overweight. DESIGN: Forty-one participants with pre-metabolic or metabolic syndrome of two ethnic groups (31 Chinese, 10 Indian), with an average body mass index (BMI) of 27.5 kg/m underwent whole-body calorimetry following 1-h cold exposure (~14.5 °C) and oral glucose tolerance test (OGTT) in a crossover design. Resting metabolic rate (RMR), respiratory exchange ratio (RER), carbohydrate oxidation (COX), and fat oxidation (FOX) were assessed. Blood glucose and insulin were measured to assess insulin sensitivity. RESULTS: Asian Indians had significantly higher fasting insulin levels and lower insulin sensitivity than Chinese participants. Chinese participants had greater increase in energy expenditure and a more pronounced fuel switch (RER, COX and FOX) with cold. For Chinese individuals, better cold-induced MetF was independently associated with lower fasting insulin and insulin resistance, even after adjusting for age, sex, and body fat. This association was not observed in Asian Indians. CONCLUSION: Significant ethnic differences exist in the association of CIT-driven MetF to insulin resistance. Chinese individuals exhibited robust MetF-insulin sensitivity correlation, whereas Asian Indians showed a blunted response without such independent association. This suggests that ethnicity-specific strategies targeting MetF are crucial for addressing metabolic health disparities.
Genetic risk, antiseizure medications, and lifestyle factors in epilepsy-associated obesity and overweight.
Wang J, He Z, Shen S … +7 more , Yi T, Liu S, Yang Q, Sander JW, Zhou D, Sima X, Li J
Int J Obes (Lond) · 2026 Jun · PMID 41942740 · Publisher ↗
BACKGROUND: Obesity is common among people with epilepsy and is influenced by genetic susceptibility, lifestyle behaviours, and antiseizure medications (ASMs). How ASMs and lifestyle factors interact with genetic risk fo...
BACKGROUND: Obesity is common among people with epilepsy and is influenced by genetic susceptibility, lifestyle behaviours, and antiseizure medications (ASMs). How ASMs and lifestyle factors interact with genetic risk for obesity in epilepsy remains unclear. METHODS: This population-based cohort study analysed UK Biobank participants with epilepsy recruited between 2006 and 2010. Polygenic risk scores for body mass index (PRS) classified individuals into low, medium, and high genetic risk groups. Associations between commonly used ASMs-including lamotrigine (LTG), valproate (VPA), carbamazepine (CBZ), and levetiracetam (LEV)-and overweight/obesity were examined using multivariable logistic regression, adjusting for demographic, socio-economic, and lifestyle factors. Gene-drug interactions were assessed, and Mendelian randomisation (MR) was used to explore potential links between LTG target gene expression and BMI. RESULTS: A total of 8451 individuals were included. In multivariable logistic regression analyses, LTG use was associated with lower odds of obesity (OR = 0.63, 95% CI: 0.47-0.85, P = 0.002) and overweight (OR = 0.72, 95% CI: 0.56-0.92, P = 0.014). VPA was associated with an increased obesity risk (OR = 1.31, 95% CI: 1.07-1.60, P = 0.010). Subgroup analysis suggested that LTG use was associated with a lower risk of obesity, particularly among individuals with low to moderate PRS. As PRS increased, the absolute difference in overweight risk between LTG users and non-users decreased. Sex-stratified analyses showed that LTG had a more substantial protective effect in males, while VPA was more strongly associated with obesity risk in females. Lifestyle factors were significantly associated with obesity and overweight risk, with higher physical activity levels and adherence to a healthy diet being associated with lower risk. MR analysis suggested a potential causal relationship between LTG target gene expression and BMI. CONCLUSIONS: Genetic predisposition, ASMs, and lifestyle behaviours were collectively associated with the risk of overweight and obesity in epilepsy. LTG use was associated with a lower risk of weight gain, particularly among individuals with lower genetic susceptibility, with this association attenuating as genetic risk for obesity increased. VPA was associated with an increased risk of obesity, especially in females. These findings support personalised metabolic risk management in epilepsy care.
A time bridge for obesity care: protein monitoring adds a timing layer to the EASO pathway while preserving the Lancet Commission definition.
Nisoli E, Carruba MO, Valerio A
Int J Obes (Lond) · 2026 Apr · PMID 41935224 · Publisher ↗
The European Association for the Study of Obesity (EASO) frames obesity care around staged, target-driven decisions. The Lancet Diabetes & Endocrinology Commission provides a disease definition-clinical obesity requires...
The European Association for the Study of Obesity (EASO) frames obesity care around staged, target-driven decisions. The Lancet Diabetes & Endocrinology Commission provides a disease definition-clinical obesity requires objective dysfunction- and distinguishes preventive strategies for preclinical obesity from therapeutic strategies for clinical obesity. Continuous protein monitoring (CPM) refers to wearable or minimally invasive sensors that repeatedly measure short panels of proteins in interstitial fluid or blood and track within-person trends over time. We hypothesize that CPM could help stratify risk and guide the timing of preventive intervention in preclinical obesity (excess adiposity, preserved function), and trigger timely escalation within the EASO pathway without changing the Commission's diagnostic criteria.
A qualitative study exploring key informant perspectives on obesity prevention efforts in France.
Hammad NM, Romieu I, Czernichow S … +7 more , Williams J, Belaabd AM, Tobias DK, Leung CW, Kenney EL, Hu FB, Willett WC
Int J Obes (Lond) · 2026 Apr · PMID 41933208 · Publisher ↗
OBJECTIVE: To explore key informants' perspectives on how France has maintained a lower obesity prevalence than other high-income countries and the challenges that may limit France's current response to the obesity epide...
OBJECTIVE: To explore key informants' perspectives on how France has maintained a lower obesity prevalence than other high-income countries and the challenges that may limit France's current response to the obesity epidemic. METHODS: Semi-structured interviews were conducted with 15 stakeholders based on their expertise and involvement in obesity clinical management, research, or policy in France. An inductive thematic analysis process was used to identify themes across the narrative data. RESULTS: Despite France's lower obesity prevalence, public health stakeholders perceive that obesity remains a growing public health concern, particularly among disadvantaged groups. Factors perceived as beneficial for obesity prevention in France included key nutrition policies such as the French National Nutrition and Health Program (PNNS), Nutri-Score (front of package labeling), physical activity prescription, and school meals, and cultural factors, namely the traditional French eating culture that encompasses structured, seated meals associated with sharing. However, factors that could prevent France from further reducing obesity rates included strong food industry lobbying, non-mandatory policies, and limited political will. CONCLUSIONS: Stakeholders believed that adherence to French eating culture, as well as several nutrition policies, has contributed to the relative success of France in mitigating the increase in obesity rates, at least in certain subgroups of the population. However, they suggest that there is still much progress to be made, given rising obesity rates driven by social disparities. Further coordination and strengthening of health-equity focused public health initiatives are needed to support efforts in obesity prevention in France.
An experimental investigation of the stigmatization of weight loss and regain from GLP-1 receptor agonist use and cessation.
Standen EC, Phelan SM, Tomiyama AJ
Int J Obes (Lond) · 2026 Apr · PMID 41933207 · Publisher ↗
BACKGROUND/OBJECTIVES: Glucagon-like peptide-1 receptor agonist medications (GLP-1s) are effective for weight loss, but when people discontinue them, they tend to regain weight. The present work sought to examine the sti...
BACKGROUND/OBJECTIVES: Glucagon-like peptide-1 receptor agonist medications (GLP-1s) are effective for weight loss, but when people discontinue them, they tend to regain weight. The present work sought to examine the stigma of losing and regaining weight after GLP-1 use and cessation. SUBJECTS/METHODS: In two randomized, between-subjects experiments, participants evaluated a fictional target after reading a brief description of the target's weight-related history, which varied by study condition. Study 1 (N = 607) aimed to understand stigma directed at individuals who lose weight using GLP-1s, so the target was described as either: having lost weight by using a GLP-1, having lost weight via diet and exercise, or not having lost weight. Study 2 (N = 706) examined stigma directed at people who regain weight after discontinuing GLP-1s, and the target was described as either: having regained weight after discontinuing a GLP-1, having regained weight after discontinuing a diet and exercise plan, not having lost weight, or having maintained weight loss. After reading, participants completed measures of weight-related stereotyping and willingness to affiliate with the target. RESULTS: In Study 1, the GLP-1 target was evaluated more negatively than the diet/exercise target and the no weight loss target. Participants' willingness to affiliate differed significantly across groups (p < 0.001), with the GLP-1 target receiving significantly lower ratings compared to the diet/exercise target (Mean difference = 0.52, 95% CI [0.27, 0.76]) and the no weight loss target (Mean difference = 0.26, 95% CI [0.02, 0.51]). In Study 2, the GLP-1 and diet/exercise targets were evaluated similarly, and both were rated more negatively than the target who maintained weight loss (ps ≤ 0.001). CONCLUSIONS: These findings suggest that people may face stigma across the cycle of losing and regaining weight after using a GLP-1, underscoring the need for stigma-reduction efforts in the context of weight management.
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