International Journal Of Obesity (2005)[JOURNAL]
Sun
200 papers
Central amygdala neuropeptide Y neurons drive hedonic ingestive behaviour independent of energy homeostasis.
Rafiei N, Mitchell CS, Jean-Richard-Dit-Bressel P … +5 more , Tedesco CR, Kumar NN, McNally GP, Herzog H, Begg DP
Int J Obes (Lond) · 2026 Jun · PMID 41933206 · Full text
BACKGROUND/OBJECTIVES: Neuropeptide Y (NPY), a key orexigenic neurotransmitter, is widely expressed in the central nervous system, including in a distinct subpopulation of neurons within the central nucleus of the amygda...
BACKGROUND/OBJECTIVES: Neuropeptide Y (NPY), a key orexigenic neurotransmitter, is widely expressed in the central nervous system, including in a distinct subpopulation of neurons within the central nucleus of the amygdala (CeA). While CeA NPY neurons contribute to energy regulation during chronic stress or high-fat diet exposure, the role of these neurons in modulating ingestive behaviour under standard conditions, particularly in response to caloric and non-caloric cues remains poorly understood. SUBJECTS/METHODS: Using state-of-the-art chemogenetic techniques, we selectively activate NPY-expressing neurons in the CeA of NPY transgenic mice, enabling precise control of their activity in freely behaving animals. RESULTS: Our experiments revealed that activation of these neurons significantly increased the consumption of both caloric and non-caloric palatable solutions, without affecting overall macronutrient preference. These findings indicate that CeA NPY neurons drive reward-related ingestive behaviour, promoting excess consumption beyond homoeostatic energy needs, regardless of the nutritional value of food. Importantly, this effect was observed independently of metabolic stress or dietary manipulation, suggesting that CeA NPY neurons engage a neural pathway that prioritizes food consumption based on reward value alone. CONCLUSION: This study provides novel insights into the neurobiological mechanisms underlying reward-driven consumption and identifies CeA NPY neurons as a key node in the neural circuitry mediating hedonic appetite. These findings have potential implications for understanding the pathophysiology of overeating and for developing targeted interventions for disorders characterized by dysregulated reward-based consumption.
γδ T cell exhaustion is associated with obesity in individuals with type 2 diabetes.
Li K, Liu G, Zhang G … +3 more , Lu E, Li P, Li P
Int J Obes (Lond) · 2026 Jun · PMID 41933205 · Publisher ↗
Obesity is a major factor driving immune exhaustion in adaptive immune cells, yet its effect on the exhaustion of peripheral circulating innate γδ T cells in individuals with type 2 diabetes (T2D) remains poorly understo...
Obesity is a major factor driving immune exhaustion in adaptive immune cells, yet its effect on the exhaustion of peripheral circulating innate γδ T cells in individuals with type 2 diabetes (T2D) remains poorly understood. In this study, we recruited 54 individuals with clinically diagnosed T2D and 30 age- and sex-matched healthy donors. We assessed peripheral blood immune cell phenotypes using flow cytometry. Compared with healthy controls, individuals with T2D showed a significant reduction in the proportion of circulating innate-like γδ T cells. Furthermore, exhaustion markers, including PD-1, Tim-3, and TIGIT, were markedly elevated on γδ T cells from T2D participants. Importantly, obesity positively correlated with the co-expression of PD-1 and TIGIT, as well as PD-1 and Tim-3, on γδ T cells. Together, these findings indicate that obesity may exacerbate the exhaustion of circulating γδ T cells in T2D, highlighting a potential link between metabolic dysregulation and innate immune dysfunction.
Mediators and moderators of successful population-level weight management in primary care: results from the PATHWEIGH cluster-randomized pragmatic trial.
Perreault L, Rodriguez C, Smith PC … +4 more , Kramer ES, Tolle L, Williams J, Pan Q
Int J Obes (Lond) · 2026 Jun · PMID 41927969 · Full text
PATHWEIGH is the first intervention scaled to 274,182 patients to mitigate population weight gain. In a stepped-wedge cluster-randomized pragmatic trial in Colorado, USA, 56 primary care clinics were randomly assigned to...
PATHWEIGH is the first intervention scaled to 274,182 patients to mitigate population weight gain. In a stepped-wedge cluster-randomized pragmatic trial in Colorado, USA, 56 primary care clinics were randomly assigned to three clusters with staggered start dates for a one-way crossover from usual care to the intervention phase. The intervention (PATHWEIGH) included: health system primary care leadership endorsement, an electronic health record (EHR)-driven care process designed to prioritize, facilitate and expedite weight management, and implementation strategies to support use of the care process and educate clinicians on obesity treatment. The objective of the current analysis was to identify mediators and moderators associated with successful population-level weight management in primary care. The majority of subgroups (moderators) benefited from the intervention because they either lost more weight, gained less weight or switched from weight gain to weight loss compared to usual care. Patient and/or provider use of an EHR component of the intervention mediated 37% of additional patient weight loss and use of an anti-obesity medication mediated 4% over 18 months (p < 0.001 for all comparisons). Altogether, the intervention had favorable effects on patient weight across the subgroups, particularly when a patient or provider used ≥1 EHR component of PATHWEIGH.
Obesity prevalence: comparison of traditional and new classification approaches in a Swiss population-based study (2005-2024).
Nehme M, Mettraux C, Chevalier C … +4 more , Dumont R, Schrempft S, Farpour-Lambert N, Guessous I
Int J Obes (Lond) · 2026 Jun · PMID 41922510 · Full text
BACKGROUND/OBJECTIVE: Obesity has traditionally been defined using body mass index (BMI), but this may overlook central adiposity and related metabolic risks. In 2025, new guidelines recommended adding anthropometric mea...
BACKGROUND/OBJECTIVE: Obesity has traditionally been defined using body mass index (BMI), but this may overlook central adiposity and related metabolic risks. In 2025, new guidelines recommended adding anthropometric measures. This study analyzed obesity prevalence comparing definitions and their associations with cardiovascular and metabolic diseases. METHODS: Using a population-based study in Geneva, Switzerland (2005-2024), we measured the prevalence of obesity based on the traditional and new definitions. Reclassification patterns were examined, and associations with diabetes, hypertension, and dyslipidemia were assessed via logistic regression and receiver operating characteristic analyses. RESULTS: Among 14,658 individuals (mean age 48.2 ± 13.7; 51.4% women), obesity prevalence ranged from 10.8% to 39.9% using new classifications, compared to 13.1% with BMI alone (p < 0.001). Reclassifications differed among men and women and with age. New classifications demonstrated superior discriminative performance for the detection of cardiovascular and metabolic outcomes compared to BMI alone. BMI + waist-to-hip ratio showed the strongest associations with diabetes (aOR 4.61; 3.87-5.47), and hypertension (aOR 3.61; 3.18-4.09), while waist-to-hip and waist-to-height ratio showed the strongest association with dyslipidemia (aOR 1.95; 1.75-2.16). CONCLUSION: Adding anthropometric measures to BMI substantially improves obesity detection. Choosing the combination of anthropometric measures and BMI with awareness of sex and age-related changes better identifies at risk individuals. This new definition can be a powerful low-cost tool in detecting individuals on the obesity spectrum early in primary care settings and prevent complications.
The relationship between weight, eating behaviours and mental health over time in the YOUTH longitudinal cohort study.
Whatnall M, Fozard T, Kolokotroni KZ … +5 more , Evans T, Marwood J, Colyvas K, Ells L, Burrows T
Int J Obes (Lond) · 2026 Jun · PMID 41922509 · Full text
BACKGROUND: Weight, eating behaviours and mental health have a complex interrelationship that is not fully understood. This study aimed to investigate the relationships between weight, eating behaviours and mental health...
BACKGROUND: Weight, eating behaviours and mental health have a complex interrelationship that is not fully understood. This study aimed to investigate the relationships between weight, eating behaviours and mental health over 12 months among socio-demographically diverse young adults (18-35 years) from the UK and Australia. METHODS: Longitudinal analysis of data from the YOUTH cohort study was conducted. Three timepoints of data were used (baseline, 6 months, 12 months), collected between 2021-2023 using online surveys hosted via the Prolific platform. The dataset includes 507, 371 and 336 participants at the respective timepoints. Random-intercept cross-lagged panel models (RI-CLPM) were used to explore the relationships between eating behaviours (addictive, disordered and emotional eating) and mental health (stress, depression, anxiety, quality of life) with weight (kilograms) over the three timepoints. RESULTS: Significant relationships were found between weight at baseline with Eating Disorder Examination Questionnaire (EDEQ) global score at 6 months (β = 0.028, p = 0.005, 95% CI = 0.009, 0.048); Positive-Negative Emotional Eating Scale (PNEES)-positive score at 6 months (β = -0.217, p = 0.011, 95% CI = -0.386, -0.053); and EDEQ shape concern score at 6 months (β = 0.040, p < 0.001, 95% CI = 0.019, 0.060) and 12 months (β = 0.034, SE = 0.010, p = 0.001, 95% CI = 0.014, 0.056). The relationships between EDEQ shape concern at baseline and weight at 12 months (β = 1.845, p = 0.005, 95% CI = -0.017, 2.927), and weight at baseline with quality of life at 12 months (β = -0.393, p = 0.034, 95% CI = -0.737, 0.031) were significant based on p value only. No other results were statistically significant for the other explanatory variables with weight. CONCLUSION: Longitudinal relationships were identified for higher weight with higher disordered eating, less eating in response to positive emotions and lower quality of life in this young adult cohort. Future research should include more longitudinal analyses of these relationships. Findings also support the need for screening of disordered eating and mental ill-health in young adults within weight management services.
Association between metabolic signatures of predicted VAT mass and risk of MASLD and other chronic liver diseases.
Wang SA, Chen HW, Zhong Q … +8 more , Xu ZY, Wei YF, Zhang CY, Li QR, Shao ZH, Liu K, Cao BF, Wu XB
Int J Obes (Lond) · 2026 Jun · PMID 41922508 · Publisher ↗
BACKGROUND AND AIMS: Visceral adipose tissue (VAT) plays a key role in metabolic dysfunction, and it is increasingly recognised as a contributor to metabolic dysfunction-associated steatotic liver disease (MASLD) and oth...
BACKGROUND AND AIMS: Visceral adipose tissue (VAT) plays a key role in metabolic dysfunction, and it is increasingly recognised as a contributor to metabolic dysfunction-associated steatotic liver disease (MASLD) and other chronic liver conditions. However, the systemic metabolic pathways linking VAT to liver disease remain unclear. This study aimed to identify metabolic signatures associated with VAT and examine their potential role as mediators in the relationship between VAT accumulation and the risks of MASLD, cirrhosis and hepatoma. METHODS: This prospective study included 269,018 UK Biobank participants without baseline liver disease. Predicted VAT mass was estimated using sex-specific models on the basis of anthropometric and bioimpedance measures. Incident liver outcomes were identified via ICD-coded hospital records. A VAT-related metabolic signature was derived from 251 circulating metabolites by using elastic net regression. Associations with liver disease risks were assessed using Cox models. Mediation analysis estimated the proportion of the VAT-MASLD association explained by the metabolic signature. RESULTS: Over a median follow-up of 14.3 years, 2658 MASLD, 671 cirrhosis and 444 hepatoma cases occurred. Each standard deviation increase in VAT was associated with increased risks of MASLD (HR: 1.70; 95% CI: 1.62-1.79), cirrhosis (HR: 1.27; 95% CI: 1.15-1.40) and hepatoma (HR: 1.15; 95% CI: 1.02-1.30). The VAT-related metabolic signature (156 metabolites, primarily lipoprotein subclasses and lipids) was independently associated with MASLD (HR: 1.89; 95% CI: 1.72-2.08) and mediated 40.0% of the VAT-MASLD association. No significant mediation was observed for cirrhosis or hepatoma. CONCLUSIONS: VAT and its metabolic signature are strongly associated with MASLD risk, partly explaining its pathogenesis through systemic metabolic alterations.
Life stage-specific heterogeneity in the effects of adiposity transition on hypertension incidence and resolution.
Meng X, Chen L, Qi Q … +3 more , Liu W, Xue Y, Yan Y
Int J Obes (Lond) · 2026 Jun · PMID 41922507 · Publisher ↗
OBJECTIVE: Whether the effects of excess adiposity on the onset and resolution of hypertension and its subtypes differ across different life stages remains unclear. We aimed to explore age-related heterogeneity in the as...
OBJECTIVE: Whether the effects of excess adiposity on the onset and resolution of hypertension and its subtypes differ across different life stages remains unclear. We aimed to explore age-related heterogeneity in the associations of excess adiposity transition with hypertension development and resolution over the life course in Chinese population. METHODS: This dynamic cohort study included 24,104 participants aged 3 to 80 years from the China Health and Nutrition Survey. We calculated the odd ratios (ORs) and confidence intervals (CIs) of excess adiposity at baseline and adiposity status transition during follow-up associated with hypertension using generalized linear mix-effects model. RESULTS: High body mass index (BMI) at baseline showed the strongest association with hypertension incidence in early adulthood (OR 2.29, 95% CI 2.14-2.45), while high waist circumference (WC) showed the strongest association in childhood (OR 3.14, 95% CI 1.75-5.20). Participants transitioning from normal to high BMI/WC had increased hypertension incidence risks across all age groups, with the strongest association observed in the 3-17 year group (BMI, OR = 2.08, 95% CI = 1.42-2.96; WC, OR = 3.41, 95% CI = 2.26-4.97). In comparison, participants transitioning from high BMI/WC to normal BMI/WC had the strongest association in the 3-17 year group for BMI (OR = 4.73, 95% CI = 0.50-57.5) and in the 18-40 year group for WC (OR = 2.52, 95% CI = 1.48-4.44). CONCLUSION: This study demonstrated life stage-specific heterogeneity in the effects of excess adiposity on hypertension, with individuals in childhood and early life conferring stronger influences. These results underscore the importance of considering age-specific approaches to weight management for hypertension prevention and control.
Beyond mean and maximum CO₂: introducing hypercapnic burden as a marker of sleep-related hypoventilation.
Kalkanis A, Eleftheriou M, Karkala A … +2 more , Buyse B, Testelmans D
Int J Obes (Lond) · 2026 Jun · PMID 41922506 · Publisher ↗
OBJECTIVES: In obesity hypoventilation syndrome (OHS), nocturnal hypoventilation can precede daytime respiratory failure. Therefore, the hypercapnic burden index was introduced to quantify sleep-related CO₂ retention. ME...
OBJECTIVES: In obesity hypoventilation syndrome (OHS), nocturnal hypoventilation can precede daytime respiratory failure. Therefore, the hypercapnic burden index was introduced to quantify sleep-related CO₂ retention. METHODS: Thirty-one patients who underwent polysomnography with transcutaneous capnography and met OHS criteria were retrospectively included in this single-center cross-sectional study. The area above the predetermined transcutaneous partial pressure of CO thresholds of 45 mmHg (thresh45) and 50 mmHg (thresh50) from the extracted capnography graphs was computed and statistical associations between the calculated areas exceeding the CO limits (OOL Area) and maximum nocturnal CO₂ (maxCO₂), mean nocturnal CO₂ (meanCO₂) and the percentage of predicted forced vital capacity (FVC%) were examined. RESULTS: Very strong positive correlations were revealed between maxCO and both thresh45 (Spearman's rho = 0.906, p < 0.000001) and thresh50 (Spearman's rho = 0.953, p < 0.000001), as well as between meanCO and both thresh45 (Spearman's rho = 0.918, p < 0.000001) and thresh50 (Spearman's rho = 0.937, p < 0.000001), thereby validating hypercapnic burden against classic nocturnal hypercapnia metrics. Significant negative correlations of these metrics with FVC% (Spearman's rho = -0.49, p = 0.01 and Spearman's rho = -0.45, p = 0.02, respectively) also supported it as a marker of functional impairment. While not outperforming classic metrics in this regard, it captured clinically relevant variability, as several outliers displayed better alignment of FVC% with threshold-based indices than with meanCO₂. CONCLUSION: This underscores the heterogeneity of nocturnal hypoventilation in OHS and the potential value of more nuanced markers in individual patients, as daytime hypercapnia might not be present yet, and maxCO and meanCO do not account for low or intermittent but cumulative CO elevations. Identifying such outliers is clinically important, as these patients may be at heightened risk of progression or may respond differently to interventions such as non-invasive ventilation.
Genetic evidence for the association between schizophrenia and obesity.
Su MH, Yeh TC, Cheng CF … +6 more , Kao WY, Lin MC, Lin YF, Chen CY, Wu CS, Wang SH
Int J Obes (Lond) · 2026 Mar · PMID 41912632 · Publisher ↗
OBJECTIVE: Observational studies found that individuals with schizophrenia (SCZ) exhibit higher prevalence of obesity-related traits, posing significant health risks. However, the neuropsychiatric mechanism remains uncle...
OBJECTIVE: Observational studies found that individuals with schizophrenia (SCZ) exhibit higher prevalence of obesity-related traits, posing significant health risks. However, the neuropsychiatric mechanism remains unclear. This study aimed to investigate the genetic connections between schizophrenia and obesity. METHODS: We examined the effect of genetic liability for SCZ on obesity in Taiwan Biobank samples of East Asian populations (N = 106,614) using linear regression models. We also performed linkage disequilibrium score regression to estimate genetic correlation in East Asian and European populations, respectively, and conducted two-sample Mendelian randomization (MR) to infer their causality in European populations. RESULTS: Our results indicated that higher genetic predisposition for SCZ was associated with lower body mass index (BMI) (beta±SE = -0.11 ± 0.01, per SD of genetic predisposition for SCZ), body fat percentage (BFP) (beta±SE = -0.16 ± 0.02), waist circumference (WC) (beta±SE = -0.20 ± 0.03), hip circumference (HC), (beta±SE = -0.17 ± 0.02) and waist-to-hip ratio (WHR) (beta±SE = -0.06 ± 0.02). SCZ showed negative genetic correlations with BMI (rg±SE = -0.15 ± 0.03 and -0.11 ± 0.01), WC (rg±SE = -0.10 ± 0.03 and -0.08 ± 0.02), and HC (rg±SE = -0.12 ± 0.03 and -0.08 ± 0.03) in both East Asian and European populations. SCZ showed negative genetic correlation with BFP in East Asian populations (rg±SE = -0.13 ± 0.03, p-value = 0.0001) but not in European populations (rg±SE = -0.02 ± 0.04, p-value = 0.62). MR analyses revealed negative causal relationships from SCZ to BMI, BFP, WC, and HC. CONCLUSIONS: This study clarified that the increased obesity prevalence in individuals with SCZ is not due to the genetic effect of SCZ itself. Rather, genetic variants associated with SCZ have a negative impact on both causality and correlations between SCZ and obesity.
Obesity and its health implications: The role of metabolic and bariatric surgery in improving physical, mental, and psychosocial well-being.
Boppre G, Bezerra A, Baena-Raya A … +4 more , Hernández-Martínez A, Soriano-Maldonado A, Zacca R, Fonseca H
Int J Obes (Lond) · 2026 Jun · PMID 41896667 · Full text
Obesity is a chronic, heterogeneous disease with profound physical, mental, and psychosocial consequences,requiring eff ective therapeutic strategies beyond lifestyle and pharmacological approaches. Metabolic and bariatr...
Obesity is a chronic, heterogeneous disease with profound physical, mental, and psychosocial consequences,requiring eff ective therapeutic strategies beyond lifestyle and pharmacological approaches. Metabolic and bariatricsurgery (MBS) has emerged as the most eff ective treatment for severe obesity, inducing substantial and sustainedweight loss alongside improvements in cardiometabolic health, quality of life, and psychosocial well-being. However,long-term outcomes vary, with some patients experiencing weight regain and persistent psychosocial challenges.This Perspective highlights the additive role of structured exercise and emphasizes the need for continuouspsychological and multidisciplinary support, positioning MBS within integrated, long-term care frameworks tooptimize patient outcomes.
Development and validation of the EDIT weight stigma reduction checklist.
de la Piedad Garcia X, Cooper K, Jardine IR … +9 more , Alberga AS, Darling KE, Hill AJ, Howes EM, Vidmar AP, Yourell J, Lister NB, Jebeile H, EDIT Collaboration Weight Stigma Working Group
Int J Obes (Lond) · 2026 May · PMID 41876679 · Full text
BACKGROUND: Weight stigma and weight discrimination refer to the negative attitudes and behaviours towards people with higher weight, because of their body size. Experiences of weight stigma in healthcare settings and wi...
BACKGROUND: Weight stigma and weight discrimination refer to the negative attitudes and behaviours towards people with higher weight, because of their body size. Experiences of weight stigma in healthcare settings and within weight management interventions contribute to poor psychological and physical health and healthcare avoidance. This study aimed to develop a checklist for healthcare professionals and providers of weight management interventions to minimize weight stigmatisation, to the extent possible, in these interventions and settings. METHODS: Based on existing literature on the contributors to weight stigma in healthcare, members of the Eating Disorders In Weight-Related Therapy (EDIT) Collaboration Weight Stigma Working Group drafted and refined the checklist items using an iterative process. The items were then pilot-tested by two reviewers. A 21-item checklist, organized into four domains: (1) planning and personnel; (2) intervention design and content; (3) outcomes and monitoring; and (4) additional components, was validated via an online survey. Healthcare professionals, researchers, and individuals with lived experience of higher weight evaluated the clarity, relevance, and importance of each item. The Content Validity Index (CVI), Content Validity Ratio (CVR), and participant feedback were used to refine the final version of the checklist. RESULTS: Respondents (n = 28, 79% women, M = 44, SD = 10.6) completed the survey. Most items were rated as clear, and 20 out of 21 items were deemed relevant to the checklist's aim (CVI range 0.61-1.0). Four items were rated as essential, with many remaining items rated as 'important but not essential'. The final checklist consists of nine items across three sections: (A) essential elements of planning/design, (B) additional considerations, and (C) feedback on the service. CONCLUSION: The EDIT Weight Stigma Reduction Checklist has value in assisting providers to design, deliver, and implement weight management interventions to take a priori action to minimise weight stigma in practice.
Clinical characteristics and survival in sarcopenic obesity defined by the Japanese working group on sarcopenic obesity criteria versus existing definitions in older adults: findings from the Otassha study.
Kera T, Kawai H, Ejiri M … +6 more , Imamura K, Sasai H, Hirano H, Fujiwara Y, Ihara K, Obuchi S
Int J Obes (Lond) · 2026 Jun · PMID 41872548 · Publisher ↗
BACKGROUND: The Japanese Working Group on Sarcopenic Obesity (JWGSO) recently published diagnostic criteria for sarcopenic obesity specific to Asian populations. This study aimed to estimate the prevalence and evaluate t...
BACKGROUND: The Japanese Working Group on Sarcopenic Obesity (JWGSO) recently published diagnostic criteria for sarcopenic obesity specific to Asian populations. This study aimed to estimate the prevalence and evaluate the characteristics and validity of sarcopenic obesity as defined by the JWGSO. METHODS: We analysed longitudinal data from 736 community-dwelling older adults aged ≥65 years from the 2012 Otassha Study. Sarcopenic obesity was diagnosed using JWGSO and European Society for Clinical Nutrition and Metabolism/European Association for the Study of Obesity (ESPEN/EASO) criteria. Physical function, body composition, gonalgia, and mobility were compared between participants with and without sarcopenic obesity according to each criterion. Agreement between JWGSO-defined sarcopenic obesity and conventional sarcopenia with obesity or ESPEN/EASO definitions was evaluated using Cohen's kappa coefficient. Survival over approximately an 8-year follow-up was evaluated using Kaplan-Meier curves and log-rank tests. Cox proportional hazards models were applied, and when the proportional hazards assumption was violated, analyses were stratified into early and late follow-up periods. RESULTS: Sarcopenic obesity was present in 57 participants (7.7%) per JWGSO criteria and 55 participants (7.5%) per ESPEN/EASO criteria. Regardless of definition, participants with sarcopenic obesity were older; had lower walking speed, grip strength, and balance; and exhibited higher prevalence of conventional sarcopenia, knee osteoarthritis, and reduced mobility function (p = 0.022 to p < 0.001). Agreement between JWGSO and conventional sarcopenic obesity and ESPEN/EASO definitions was fair (K = 0.345) and substantial (K = 0.671), respectively. JWGSO-defined sarcopenic obesity was not significantly associated with mortality in the early follow-up but was linked to increased mortality risk in the late period (HR 3.75, 95% CI 1.66-8.50, p = 0.002). CONCLUSION: Sarcopenic obesity defined by the JWGSO is distinct from conventional sarcopenia with obesity and ESPEN/EASO-defined sarcopenic obesity. This population-specific criterion may improve identification of older Japanese adults at higher risk of poor physical function and mortality, although further validation is warranted.
A sequential deep learning model for predicting people with obesity in adults aged 18-64 using physical fitness variables.
Li X, Sung Y, Zhang Y … +3 more , Lim B, Kim DY, Bae JH
Int J Obes (Lond) · 2026 Mar · PMID 41862701 · Publisher ↗
BACKGROUND/OBJECTIVES: Health of people with obesity is a global concern. We developed an explainable sequential deep learning model using nationally representative physical fitness data to predict people with obesity an...
BACKGROUND/OBJECTIVES: Health of people with obesity is a global concern. We developed an explainable sequential deep learning model using nationally representative physical fitness data to predict people with obesity and to identify the most influential predictors. SUBJECTS/METHODS: We analyzed data from 204,334 adults collected between 2010 and 2023. A sequential neural network model was trained and evaluated using stratified 5-fold cross-validation. Model performance was assessed using accuracy, precision, recall, F1-score, and ROC-AUC, as well as MAE, MSE, and R². Explainability was examined using SHAP and LIME analyses to rank feature importance and interpret decision patterns. RESULTS: Across five stratified folds, the model achieved an overall accuracy of 0.87-0.88 (p < 0.001 vs. random). Fold 4 showed optimal performance (TN = 1,462; FN = 184; FP = 249; TP = 1,554), yielding an accuracy of 0.873 (precision = 0.866, recall = 0.855, F1 = 0.876, ROC-AUC = 0.95) and stabilizing at 20 epochs. For this model, MAE was 0.122, MSE was 0.041, and R² was 0.833, with an average prediction error of 0.171 for the first 50 samples. SHAP identified 20-m shuttle run estimated VO₂max (importance = 0.339), gender (0.2481), and relative grip strength (0.135) as the top predictors. LIME (intercept = 0.511, predicted=0.668, R² = 0.995) indicated that low estimated VO₂max ( < 28.71 ml/kg/min) and low relative grip strength ( < 38.17%) substantially increased the probability of obesity classification, particularly among females. CONCLUSIONS: This explainable sequential deep learning model accurately predicts people with obesity using physical fitness variables and highlights the critical role of cardiorespiratory fitness in obesity risk assessment and management.
Associations between dietary glycemic and insulinemic patterns and eating behavior in adults: a cluster-based analysis.
Ulug E, Ersoy N, Acikgoz Pinar A
Int J Obes (Lond) · 2026 Apr · PMID 41851490 · Publisher ↗
BACKGROUND: Although eating behavior may be influenced by the type and amount of carbohydrates and insulin-stimulating nutrients consumed, studies specifically addressing these dietary characteristics in relation to eati...
BACKGROUND: Although eating behavior may be influenced by the type and amount of carbohydrates and insulin-stimulating nutrients consumed, studies specifically addressing these dietary characteristics in relation to eating behavior are extremely limited. Therefore, the purpose of this study was to investigate the connections between different aspects of adult eating behavior and dietary glycemic and insulinemic indices. METHODS: A total of 561 healthy adults aged 19-64 years were assessed in this study. Dietary intake was evaluated with a semiquantitative food frequency questionnaire, and glycemic index (GI), glycemic load (GL), insulin index (II), and insulin load (IL) were calculated. Participants were categorized into three clusters based on their dietary glycemic parameters (GI, GL, and carbohydrate intake) and separately into three clusters based on insulinemic parameters (II, IL, and energy intake) using k-means clustering. The body weight, height, waist and hip circumference were measured. Eating behavior was evaluated using the Three-Factor Eating Questionnaire-Revised 18 (TFEQ-R18) and the Food Cravings Questionnaire-Trait (FCQ-T). RESULTS: The mean BMI was significantly lower in Cluster I, whereas waist and hip circumference did not differ across glycemic clusters. For insulinemic clusters, Cluster III had the highest BMI, waist and hip circumference (p < 0.05). Participants in the high-GL cluster exhibited significantly higher emotional and uncontrolled eating scores, along with greater susceptibility to food-related cues, negative emotions, and guilt (p < 0.05). Similarly, individuals in the high-IL cluster reported elevated scores in emotional and uncontrolled eating and food craving subscales related to positive and negative reinforcement, emotional triggers, and loss of control (p < 0.05). In contrast, both in low GI/GL and in low-II/IL clusters displayed more favorable eating behavioral patterns. These associations remained significant after adjusting for confounders (age, gender, BMI, and waist circumference). CONCLUSION: Increased food cravings and maladaptive eating patterns are associated with diets that have higher glycemic or insulin loads. Beyond merely controlling energy intake, dietary interventions that are self-regarding glycemic and insulinemic properties may improve behavioral regulation of eating.
Weight loss independent outcomes in type 2 diabetes mellitus and other metabolic comorbidities after Roux-en-Y gastric bypass and sleeve gastrectomy.
Hedberg S, Näslund E, Ottosson J … +1 more , Stenberg E
Int J Obes (Lond) · 2026 May · PMID 41851489 · Full text
BACKGROUND/OBJECTIVES: Studies show equal or better resolution of type 2 diabetes mellitus (T2D) and other metabolic outcomes after Roux-en-Y gastric bypass (RYGB) compared to sleeve gastrectomy (SG), but it is unclear w...
BACKGROUND/OBJECTIVES: Studies show equal or better resolution of type 2 diabetes mellitus (T2D) and other metabolic outcomes after Roux-en-Y gastric bypass (RYGB) compared to sleeve gastrectomy (SG), but it is unclear whether this is related only to the higher weight loss after RYGB, or if there are weight-loss-independent factors. The objective of this study was to examine weight-loss-independent differences in metabolic outcomes between RYGB and SG. METHODS: This study utilized the Scandinavian Obesity Surgery Registry and the Swedish National Diabetes Register. All included patients had presurgical T2D and matching was between RYGB or SG using a 1:1 propensity score, matching with a generalized linear model including age, sex, BMI at baseline, comorbidities (cardiovascular, dyslipidemia, sleep apnea, and hypertension), T2D parameters at baseline (HbA1c, number of T2D medications, insulin use, duration of T2D), year of surgery and percentage Total Weight Loss (%TWL) at nadir. The ensuing cohort was compared regarding remission and improvements in T2D, and other cardiometabolic outcomes, including major adverse cardiovascular events (MACE). RESULTS: 1440 individuals (720 RYGB; 720 SG) were matched 1:1 using Propensity score. There were 494 (68.6%) patients in complete T2D remission at 2 years after RYGB, and 438 (60.8%) after SG, (OR: 0.75, 95% CI 0.60 - 0.93, p = 0.010) despite similar TWL (Standardized mean difference 0.12). SG also had a lower rate of pharmacological remission for T2D (OR 0.71, 95% CI 0.56-0.88, p = 0.002), and hypertension remission (OR 0.70, 95% CI 0.52-0.94, p = 0.019), but there was no significant difference in pharmacological remission regarding dyslipidemia (OR 0.83, 95%CI 0.66-01.04, p = 0.11). No difference was seen in the risk for MACE (SG vs. RYGB HR:1.45, 95%CI 0.89-2.38, p = 0.136). CONCLUSIONS: RYGB is associated with a greater rate of T2D remission compared to SG. This study suggests that these improved outcomes are independent of the degree of weight loss.
Association of body mass index, waist circumference, (abdominal) overweight and obesity with sex- and age-specific cognitive function over time-the Doetinchem Cohort Study.
Te Hoonte F, Rietman ML, Wesenhagen KEJ … +2 more , Picavet HSJ, Verschuren WMM
Int J Obes (Lond) · 2026 May · PMID 41845046 · Full text
BACKGROUND: Having obesity is a risk factor for cognitive decline and dementia. It remains unclear whether timing of obesity during someone's lifespan affects this association. AIM: To study the association of body mass...
BACKGROUND: Having obesity is a risk factor for cognitive decline and dementia. It remains unclear whether timing of obesity during someone's lifespan affects this association. AIM: To study the association of body mass index (BMI), waist circumference (WC), and having (abdominal) overweight and obesity with cognitive function and decline, and whether these associations were modified by age. METHODS: 3873 participants (aged 45-70 at baseline, 52% women) from the Doetinchem Cohort Study were included, with up to six repeated measures. Participants were classified as having (abdominal) obesity if they had a BMI ≥30 kg/m² or WC ≥102 cm (men) or ≥88 cm (women). Domain scores for global cognition, memory, flexibility, and processing speed were calculated by standardizing individual test scores at baseline. Associations of time-dependent BMI, WC, and (abdominal) overweight and obesity with cognitive function and decline were studied using linear mixed models. Models were sex-stratified and adjusted for socio-demographic, lifestyle, and mental health factors. Modification by age (≤ or >55 years at baseline) was evaluated using interaction terms. RESULTS: Higher BMI and WC were associated with worse level of cognition (all domains). For both sexes, the smallest difference was for global cognition (BMI) and processing speed (WC), the largest for flexibility (BMI) and memory (WC). Furthermore, having (abdominal) obesity, compared to a healthy BMI/WC, was consistently associated with worse memory function in both sexes. Effect sizes were generally larger for categorical WC compared to categorical BMI. In men, abdominal obesity was associated with accelerated decline in processing speed (all ages), and with accelerated decline in global cognition and flexibility ( > 55 years). CONCLUSIONS: In both sexes, higher BMI and WC were consistently associated with worse cognition. WC-based overweight and obesity showed larger effect sizes with cognition than BMI-based overweight and obesity. Only in men, associations with cognitive decline and effect modification by age were observed.
Longitudinal prediction of BMI using explainable AI: integrating polygenic scores, maternal, early-life and familial factors.
Chen F, Melton PE, Vinsen K … +3 more , Mori T, Beilin L, Huang RC
Int J Obes (Lond) · 2026 May · PMID 41839989 · Full text
BACKGROUND/OBJECTIVES: This study aimed to predict body mass index (BMI) trajectories from childhood to early adulthood using explainable artificial intelligence, integrating adult BMI polygenic scores (PGS), maternal, e...
BACKGROUND/OBJECTIVES: This study aimed to predict body mass index (BMI) trajectories from childhood to early adulthood using explainable artificial intelligence, integrating adult BMI polygenic scores (PGS), maternal, early-life, and familial factors to identify key predictors of obesity risk and inform prevention strategies. SUBJECTS/METHODS: We analyzed longitudinal data from the Raine Study Gen2 cohort, recruiting 2868 participants. This observational study, without randomization or case-control design, collected BMI measurements at ages 8, 10, 14, 17, 20, 23, and 27 years. We applied Kolmogorov-Arnold Networks (KAN) alongside conventional machine learning models, integrating epidemiological variables (maternal and paternal anthropometrics, parental education, early-life skinfold measurements) with seven BMI-related PGS. The analysis spanned from childhood to early adulthood, with no intervention administered. RESULTS: The KAN model, combining epidemiological and PGS data, achieved predictive performance with R² ranging from 0.81 for BMI at age 8 to 0.34 at age 27. BMI z-score at age 5 was the dominant predictor in early years, with adult BMI PGS influence increasing post-adolescence. Maternal and paternal anthropometry, parental education, and early-life skinfold measurements were significant contributors. CONCLUSIONS: The interpretable KAN model revealed the dynamic interplay of childhood BMI z-score and PGS emerging as key drivers of BMI trajectories across life stages. The finding underscores the potential of BMI at critical time in early childhood as a biomarker for obesity risk. Our interpretable model offers actionable insights for targeted obesity prevention strategies.
Assessment of the elasticity of lipedematous tissue and the examination of the relationship between pain and fibrosis in lipedema.
Yaman A, Mansız-Kaplan B
Int J Obes (Lond) · 2026 May · PMID 41832313 · Publisher ↗
BACKGROUND/OBJECTIVES: Lipedema is a chronic and progressive adipose tissue disorder characterized by the abnormal accumulation of subcutaneous fat, predominantly in the legs and occasionally in the arms. The symptom tha...
BACKGROUND/OBJECTIVES: Lipedema is a chronic and progressive adipose tissue disorder characterized by the abnormal accumulation of subcutaneous fat, predominantly in the legs and occasionally in the arms. The symptom that most significantly affects the quality of life is pain. Ultrasound elastography is an imaging technology that allows for measuring tissue stiffness quantitatively. This study aims to evaluate the relationship between accompanying pain in patients with lipedema and tissue elasticity measured using shear-wave elastography (SWE). METHODS: Our study was designed as an observational, analytical and cross-sectional study. The visual analog scale (VAS) was used to assess pain, while the PainDetect questionnaire was utilized to evaluate neuropathic pain. The evaluation of tissue elasticity and fibrosis was conducted using the SWE method. RESULTS: This research assessed thirty-five patients, revealing an average age of 45.2 years and an average body mass index (BMI) of 33.6 kg/m². 60% of the patients had a lipedema diagnosis in their family history. Both age (p < 0.01) and BMI (p < 0.001) values were moderately correlated with all subcutaneous adipose tissue measurements, while no correlation was observed in SWE measurements. Only the level of the thigh in the SWE-Elasticity (SWE-E) values was related to VAS (r = 0.35, p = 0.03). Additionally, PainDetect scores demonstrated significant positive correlations with both SWE-velocity (SWE-V) and SWE-E measurements in the thigh region. Specifically, SWE-V showed moderate correlations with PainDetect scores in the right thigh (r = 0.38, p = 0.02) and left thigh (r = 0.47, p = 0.004), while SWE-E was also significantly correlated in both the right (r = 0.44, p = 0.007) and left thighs (r = 0.44, p = 0.008). CONCLUSIONS: While SWE measurements were not correlated with skin adipose tissue, SWE measurements were correlated with pain and neuropathic pain in patients with lipedema. This finding highlights a potentially important relationship between tissue elasticity and pain, which may warrant further exploration. SWE offers a novel, non-invasive approach to quantifying tissue stiffness, providing valuable insights into tissue alterations in women with lipedema.
Exploring the interaction of obesity and allergy and the potential roles of gut microbiota in the development of this comorbidity in male mice.
Miao Z, Jiang F, Li J … +8 more , Wu S, Zhang X, Mao Y, Su S, Han W, He F, Wu X, Cheng R
Int J Obes (Lond) · 2026 May · PMID 41832312 · Publisher ↗
BACKGROUND: Plenty of epidemiological studies have focused on obesity and allergic diseases, less is known about the interaction of the comorbidity. OBJECTIVE: The present study was conducted to identify the relationship...
BACKGROUND: Plenty of epidemiological studies have focused on obesity and allergic diseases, less is known about the interaction of the comorbidity. OBJECTIVE: The present study was conducted to identify the relationship between obesity and allergy and to clarify the potential regulatory roles of gut microbiota in the development of comorbidity. METHODS: Four-week-old male BALB/c mice were used to establish the comorbidity model. The high-fat diet was used to induce obese mice, and ovalbumin was used to induce allergic mice. The post-obesity allergy mice and post-allergy obesity mice (n = 12/group) were used to clarify the effects of obesity on allergic reactions and those of allergy on metabolic function. Changes in gut microbiota, short-chain fatty acids (SCFAs), bile acids (BAs), the expression of the SCFAs and the BAs receptors were also detected. RESULTS: In the post-obesity allergy study, the serum Immunoglobulin E and the splenic CD4CD25FOXP3 T cells (Tregs) in post-obesity allergic mice were higher than that in allergic mice. Post-obesity allergic mice had higher abundance of Alistipes, Parabacteroides, Rikenellaceae_RC9_gut_group, Colidextribacter, Muribaculum, Lachnospiraceae_NK4A136_group, and Erysipelatoclostridium but lower levels of SCFAs and expressions of GPR41 and 43. In the post-allergy obesity study, OVA-induced allergy alleviated fat accumulation and glycolipid metabolism disorder in obese mice. However, there was no significant difference in the gut microbiota and the SCFAs receptors between post-allergy obese mice and obese mice, except for BAs. CONCLUSIONS: The post-obesity allergy model suggested that early obesity impaired allergic reaction and immune function, which aggravated the development of allergy via altering the composition of the gut microbiota and the contents and function of SCFAs. The post-allergy obesity study suggested that early allergy did not promote metabolic disorder, instead of alleviating the development of obesity, and BAs may contribute to this alleviation.
Inversed impaired osteogenic activity in children with severe obesity due to MC4R deficiency compared to LEP and LEPR deficiency.
Janjua QM, Khanam R, Saeed S … +6 more , Manzoor J, Haseeb A, Hanook S, Bonnefond A, Arslan M, Froguel P
Int J Obes (Lond) · 2026 Jun · PMID 41826632 · Full text
OBJECTIVE: Chronic obesity is associated with impaired bone health. However, few investigations have been conducted to assess bone physiology in early-onset obesity. In this study, we measured specific bone turnover and...
OBJECTIVE: Chronic obesity is associated with impaired bone health. However, few investigations have been conducted to assess bone physiology in early-onset obesity. In this study, we measured specific bone turnover and metabolic biomarkers in children with severe obesity with biallelic loss-of-function variants of the leptin (LEP), leptin receptor (LEPR), or melanocortin 4 receptor (MC4R) genes. METHODS: Thirty-nine children aged 0.3-8.8 years with a BMI SDS ≥ 3, previously identified with pathogenic variants in LEP, LEPR, or MC4R, were recruited for the current study. Additionally, 13 age-matched children with severe obesity who tested negative for variants in known obesity-related genes were included, and another 13 unrelated age-matched children with normal body weight served as the control group. Serum osteocalcin, osteopontin, osteoprotegerin, and sclerostin levels were assessed using multi-analyte profiling. Serum leptin, insulin, and cortisol levels were determined using ELISA. RESULTS: Serum levels of osteocalcin and osteopontin, specific markers of bone formation, were significantly lower in children with LEP and LEPR biallelic variants than in the control group. In contrast, the values of these two biomarkers in children with MC4R deficiency were significantly higher than those in the other groups. No differences were observed in the bone resorption markers osteoprotegerin and sclerostin. Hyperleptinemia was more pronounced in children with LEPR deficiency. Serum insulin concentrations were elevated in individuals with MC4R deficiency, whereas serum cortisol levels were significantly higher in children with LEP deficiency than in all other groups. CONCLUSION: Our data demonstrate that osteogenic activity (but not resorption activity) is differentially affected in children with complete genetic disruption of the leptin-signaling pathway. Children with MC4R deficiency showed higher osteogenic markers, but children with LEP and LEPR deficiencies showed the opposite. Our results support the usefulness of bone turnover biomarkers for the assessment and management of bone health in different types of obesity.
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