International Journal Of Obesity (2005)[JOURNAL]
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200 papers
Energetic adaptations to weight loss in children and adolescents with obesity: a systematic review and meta-analysis.
Siroux J, Moore H, Lonjou P … +5 more , Gaucherot A, Beraud D, Boirie Y, Isacco L, Thivel D
Int J Obes (Lond) · 2026 May · PMID 41826631 · Publisher ↗
BACKGROUND: While weight loss often triggers adaptations to prevent further weight loss, these remain understudied and under-considered in the context of pediatric obesity. This systematic review and meta-analysis is the...
BACKGROUND: While weight loss often triggers adaptations to prevent further weight loss, these remain understudied and under-considered in the context of pediatric obesity. This systematic review and meta-analysis is the first to provide a comprehensive synthesis of the available evidence regarding the adaptations of the components of total energy expenditure (EE) in response to weight loss in children and adolescents with overweight/obesity (OW/OB), considering the intervention types (e.g., dietary, multidisciplinary, pharmacotherapy, bariatric surgery, or physical activity-based). METHODS: Articles reporting on weight loss interventions of any type that included an assessment of EE based on indirect calorimetry were identified through a search of MEDLINE, EMBASE, and COCHRANE databases up to September 2024. RESULTS: Of the initial 1723 references found, 31 were included, representing 53 intervention arms. The meta-analysis revealed a small but non-significant decrease in resting EE (REE) after weight loss (Mean Change (MC) = -130.91 [-492.67, 230.86] kJ, p = 0.467), regardless of the intervention type. However, the systematic review suggests that the degree of weight loss and multidisciplinary studies (particularly those involving caloric restriction) appear to result in a greater decrease in REE, especially in girls, and during short-term interventions. REE relative to fat-free mass (FFM) (MC = -0.95 [-6.11, 4.21] kJ.kg, p = 0.700) and physical activity-induced EE (PAEE) (MC = 45.47 [-22.93, 113.87] kJ, p = 0.155) were not meaningfully altered. The heterogeneity of the proposed intervention duration and the high inter-individual variability in body weight and composition changes could have contributed to these modifications. CONCLUSION: The present results highlight the need for further well-controlled and designed studies, especially when it comes to the thermic effect of food, and the need to consider the patients' individual profiles and responses to interventions.
The impact of slope-adjusted visit-to-visit body mass index variability on early dementia risk prediction.
Satoh M, Nobayashi H, Yagihashi T … +9 more , Iwabe Y, Izumi S, Murakami T, Suzuki Y, Toyama M, Nakayama S, Muroya T, Fujimori J, Metoki H
Int J Obes (Lond) · 2026 May · PMID 41826630 · Full text
BACKGROUND: Previous studies have not typically separated body mass index (BMI) slope and variability as distinct constructs when examining dementia risk. This study assessed the association between the slope-adjusted vi...
BACKGROUND: Previous studies have not typically separated body mass index (BMI) slope and variability as distinct constructs when examining dementia risk. This study assessed the association between the slope-adjusted visit-to-visit BMI variability and dementia risk. SUBJECTS/METHODS: We conducted a retrospective cohort study using Japanese national health insurance data (2015-2023) of individuals aged 50-74 years who underwent five annual health checkups. BMI variability was assessed using the slope-adjusted standard deviation (SD) to account for underlying temporal trends. The proxy outcome for dementia was antidementia drug initiation, analyzed using Fine-Gray competing risk models, accounting for death as a competing risk. RESULTS: During the mean 2.17 ± 1.19 years of follow-up among 303,042 participants (mean age: 66.6 years, men: 38.6%), antidementia drugs (predominantly donepezil: 67.4%) were initiated in 665 and 2394 died. After adjusting for covariates including BMI at baseline and annual BMI change, the highest tertile of slope-adjusted BMI-SD (≥0.50 kg/m²) was significantly associated with increased dementia risk compared with the lowest tertile (≤0.31 kg/m²). Annual BMI change showed a U-shaped association with dementia risk, with pronounced elevation in the first tertile (BMI decline ≤-0.31%, hazard ratio: 1.60, 95% confidence interval: 1.32-1.93). In the basic model including baseline covariates except BMI at baseline, there was no significant difference in the C-statistics improvements when BMI at baseline or adding slope-adjusted BMI-SD (+0.0147 vs +0.0146) were added, while the greatest C-statistics improvement was observed when BMI decline ≤-0.31% was added. The association between the highest slope-adjusted BMI-SD tertile and dementia risk was stronger in females than males (P for interaction = 0.0039). CONCLUSIONS: Slope-adjusted visit-to-visit BMI variability is independently associated with dementia risk, particularly among females, while BMI decline patterns are strong risk factors of dementia. Incorporating longitudinal monitoring of visit-to-visit BMI variability into routine dementia screening may be beneficial.
Associations between dietary intake of flavonoids and adiposity: cross-sectional findings from the Fenland Study, the United Kingdom.
Gil-Lespinard M, Forouhi NG, Imamura F … +1 more , Zamora-Ros R
Int J Obes (Lond) · 2026 May · PMID 41820621 · Publisher ↗
BACKGROUND: Prospective and experimental evidence supports beneficial effects of flavonoids on weight management and metabolic health, but their impact on specific adiposity parameters remains unclear. We aimed to invest...
BACKGROUND: Prospective and experimental evidence supports beneficial effects of flavonoids on weight management and metabolic health, but their impact on specific adiposity parameters remains unclear. We aimed to investigate associations of total and subclasses of dietary flavonoids with adiposity markers, several of which have been linked to metabolic risk. METHODS: We evaluated cross-sectional data from 11,568 adults recruited to the Fenland Study between 2005 and 2015 in Cambridgeshire, the United Kingdom. Habitual diets were evaluated using food frequency questionnaires. Flavonoid intakes were calculated mainly using the United States Department of Agriculture food composition databases. We examined associations using robust regression adjusted for relevant confounders and corrected for false discovery rate (FDR) for multiple flavonoids and adiposity parameters: body fat (BF) (dual-energy X-ray absorptiometry), visceral fat (VAT), subcutaneous fat (SCAT), body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), VAT:SCAT ratio, and a body shape index (ABSI). RESULTS: Median flavonoid intake was 428 mg/d (interquartile range 258.5-568.6). Doubling in total flavonoid intake was inversely associated with BF [beta -0.54% (95% CI -0.70; -0.40)]; VAT [-0.13 cm (-0.17; -0.08)]; SCAT [-0.05 cm (-0.08; -0.02)]; BMI [-0.33 kg/m (-0.44; -0.22)]; WC [-0.84 cm (-1.13; -0.55)]; and WHR [-0.004 (-0.006; -0.002)]. Most of flavonoid subclasses showed similar results, except isoflavones that were positively associated with BF, VAT and WC. Intakes of proanthocyanidins and anthocyanidins showed the strongest negative associations independently of BMI. Subgroup analyses resulted in stronger negative associations in women, older adults, and non-smokers. CONCLUSION: Flavonoids may influence adiposity, a potential pathway for the relationship between flavonoid-rich foods and metabolic risk. Proanthocyanidins and anthocyanidins may affect site-specific fat distribution, particularly visceral adiposity. Further investigation in prospective, interventional, and mechanistic studies is warranted to understand the link between flavonoids and adiposity.
The effects of time-restricted eating on energy balance regulation in adults with overweight/obesity and type 2 diabetes.
Kramer CK, Zinman B, Feig DS … +1 more , Retnakaran R
Int J Obes (Lond) · 2026 Jun · PMID 41814085 · Publisher ↗
BACKGROUND/OBJECTIVES: Time-restricted eating (TRE) induces a metabolic shift in substrate utilization increasing lipolysis and ketogenesis. These metabolic changes raise the possibility of a differential effect on energ...
BACKGROUND/OBJECTIVES: Time-restricted eating (TRE) induces a metabolic shift in substrate utilization increasing lipolysis and ketogenesis. These metabolic changes raise the possibility of a differential effect on energy balance regulation following TRE-induced weight loss. The aim of this study is to evaluate the impact of TRE on energy balance homeostasis in individuals with overweight/obesity and type 2 diabetes (T2DM) who participated in a recently reported trial achieving substantial weight reduction (-3.86% body weight). SUBJECTS/METHODS: In this randomized cross-over trial, 39 participants with overweight/obesity and T2DM were randomized to either 6 weeks of TRE (20 h fasting/4 h eating) or standard lifestyle, followed by 4-week washout and then the other dietary intervention for 6 weeks. At each study visit at baseline, 6-, 10-, and 16-week participants completed a 75 g oral glucose tolerance test (OGTT). We measured fasting and post-challenge responses of glucose, glucagon, GLP-1, ghrelin, leptin, and peptide YY. RESULTS: TRE-induced calorie deficit as participants self-reported ingested -384 ± 488 Kcal/day less during TRE as compared to the standard lifestyle period (P < 0.001) with no differences in macronutrient distribution. There were no differences in responses to OGTT induced by TRE as compared to standard lifestyle for glucagon (AUC 0.04 ± 23.5, P = 0.99), GLP-1 (AUC 1.6 ± 67.6, P = 0.98), ghrelin (AUC 31.0 ± 32.4, P = 0.35), and peptide YY (AUC -33.9 ± 65.6, P = 0.61). Importantly, TRE-induced weight loss promoted a significant decrease in both fasting leptin (-2445 ± 885 ng/mL, P = 0.009) and leptin response to OGTT (AUC -12776 ± 3088, P < 0.001) as compared to standard lifestyle. In addition, a significant increase in fasting ghrelin (28 ± 11.3 pg/mL, P = 0.02) was observed post-TRE as compared to pre-intervention. CONCLUSIONS: These findings demonstrate that TRE does not prevent the physiologic compensatory changes associated with weight reduction in individuals with overweight/obesity and T2DM.
Longitudinal associations between screen time and whole-body adiposity during the first decade of life: insights from the GUSTO cohort.
Vainqueur C, Padmapriya N, Tint MT … +13 more , Yap F, Lee YS, Saw SM, Tan KH, Shek LP, Chong YS, Godfrey KM, Eriksson JG, Lioret S, Heude B, Müller-Riemenschneider F, Bernard JY, Poncet L
Int J Obes (Lond) · 2026 May · PMID 41803381 · Publisher ↗
BACKGROUND/OBJECTIVES: Childhood obesity remains a pressing public health challenge worldwide. With screen viewing emerging as a major contributor to sedentary time, it is crucial to assess the extent to which screen vie...
BACKGROUND/OBJECTIVES: Childhood obesity remains a pressing public health challenge worldwide. With screen viewing emerging as a major contributor to sedentary time, it is crucial to assess the extent to which screen viewing contributes to excessive body fat in children. The aim of this study was to examine the associations between screen time and subsequent adiposity in children from the Singapore GUSTO cohort. SUBJECTS/METHODS: At ages 2 and 3 years, parents reported their child's screen time, including television and handheld devices. Body fat was assessed repeatedly between ages 4 and 10 years using various methods, including body mass index (BMI), BMI z-score (zBMI), skinfold thicknesses, and whole-body body fat percentage using air displacement plethysmography (BOD POD) and/or quantitative magnetic resonance (EchoMRI). Among 935 children, we examined associations between average screen time from 2-3 years and adiposity using generalized estimating equations, adjusted for potential confounders and stratified by child sex. RESULTS: The average ( ± SD) screen time at 2-3 years was 2.5 ( ± 1.8) h/day. At 8 years, average body fat percentage measured by BOD POD was 21.8% ( ± 9.1) in boys and 20.5% ( ± 8.9) in girls. In the overall sample, there were no associations between screen viewing time and adiposity. However, each one-hour increase in total screen time (β [95% CI] = 0.40 [0.05, 0.75] % per h/day) and television time (0.55 [0.10, 1.00] %) was associated, among boys, with greater whole-body fat percentage from 4 to 9 years. Consistent associations were found with skinfold thicknesses, but not with BMI/zBMI. No associations were found with handheld device time, nor among girls. CONCLUSIONS: Greater screen time, notably television time, was prospectively associated with greater adiposity among boys, but not in girls. Future studies should investigate the potential mediating mechanisms involved in this sex-specific relationship. STUDY REGISTRATION: This cohort study was registered on the 4 of August, 2010 and is available online at ClinicalTrials.gov: NCT01174875.
Weight-related changes in MRI-derived measures of body composition and liver steatosis: a large-scale analysis for obesity trial design.
Nowak M, Núñez L, Pagliaro T … +7 more , Robson MD, Duncker C, Kaplan LM, Heymsfield SB, Thomaides Brears H, Bell JD, Thomas EL
Int J Obes (Lond) · 2026 May · PMID 41776341 · Full text
BACKGROUND/OBJECTIVES: Amid rising global obesity rates and advances in weight-loss therapies, monitoring body composition and ectopic fat could refine trial design. We quantified weight-related changes in body compositi...
BACKGROUND/OBJECTIVES: Amid rising global obesity rates and advances in weight-loss therapies, monitoring body composition and ectopic fat could refine trial design. We quantified weight-related changes in body composition and liver steatosis prior to widespread adoption of incretin treatments. SUBJECTS/METHODS: Adults (N = 3070) from the UK Biobank with repeat abdominal MRI scans were included. Percent weight change from baseline was categorised: stable (0 ± 2%), mild change (2-5% weight gain/loss), moderate change (5-10% weight gain/loss), or large change (10-15% weight gain/loss). INTERVENTION/METHODS: MRI data were processed automatically from two visits, spaced 2.7 years apart, to derive volumetric visceral (VAT), subcutaneous adipose tissue (SAT), total skeletal muscle volume (SM, or indexed SM), muscle fat infiltration (MFI), and psoas muscle cross-sectional area (CSA) in the abdominal region. Liver fat content (LFC) was assessed using LiverMultiScan. Dual-energy x-ray absorptiometry (DXA) measurements were compared. RESULTS: Weight gain occurred in 28% of all subjects (N = 3070, age 63 years, male 49%, 13% with obesity, 43% with overweight). Moderate or large weight gain increased LFC, VAT, SAT, MFI, and SM (all p < 0.001). Weight loss also occurred in 28%. Decreases were observed with moderate or large weight loss in LFC, VAT, SAT, SM, SMI, and psoas CSA (all p < 0.001). MFI was reduced with large weight loss. For VAT and liver fat, prevalent type 2 diabetes exacerbated weight gain-related increases, and blood pressure medication attenuated the impact of weight change. For individuals with overweight or obesity, for every 5% drop in weight, there was 16% reduction in VAT, 11% in SAT, 24% in liver fat, 2.3% in MFI, 1.5% in SM (or 1.4% in SMI) and 2.1% in psoas CSA. DXA changes in lean mass correlated weakly with changes in SM volume (rho 0.28-0.47). CONCLUSIONS: Using MRI, relative changes in body composition and liver steatosis resulting from weight loss can inform clinical trials, including placebo arm design and power estimations. Weight changes affect body composition and liver fat and can inform obesity trial design.
Age-dependent obesity paradox in acute myocardial infarction prognosis: a cohort study of body mass index and recurrent myocardial infarction.
Zhang L, Liu Z, Zeng J … +1 more , Wu M
Int J Obes (Lond) · 2026 May · PMID 41764327 · Full text
BACKGROUND: Obesity is a known cardiovascular risk factor, but the "obesity paradox" has been observed in patients with acute myocardial infarction (AMI), where obesity may be linked to better survival outcomes. The rela...
BACKGROUND: Obesity is a known cardiovascular risk factor, but the "obesity paradox" has been observed in patients with acute myocardial infarction (AMI), where obesity may be linked to better survival outcomes. The relationship between body mass index (BMI) and recurrent myocardial infarction, particularly with age-specific effects, remains unclear. METHODS: This retrospective cohort study included 4023 AMI patients from a tertiary medical center (2015-2023). Patients were stratified by age: ≤60 years (n = 1277) and >60 years (n = 2746). Multivariable-adjusted Cox proportional hazards models were used to assess the association between BMI and recurrent myocardial infarction, adjusting for demographics, biomarkers [N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT)], imaging parameters [left ventricular ejection fraction (LVEF)], comorbidities, and treatment regimens. Curve-fitting models were also applied. The median follow-up time was 35 months (Q1-Q3 25-58). RESULTS: In the ≤60 years group, higher BMI was associated with a significantly lower risk of recurrent myocardial infarction [adjusted hazard ratio (HR) = 0.965, 95% confidence interval (CI) 0.936-0.994, P = 0.018]. In contrast, the >60 years group showed a trend toward higher risk (unadjusted HR = 1.032, 95% CI 1.012-1.053, P = 0.001), which lost statistical significance after adjustment (adjusted HR = 1.015, 95% CI 0.994-1.037, P = 0.151). Curve fitting revealed a negative linear correlation in the ≤60 years group and a positive relationship in the >60 years group. CONCLUSIONS: This study presents the first evidence of an age-dependent obesity paradox in AMI. In patients aged ≤60 years, higher BMI reduced recurrent myocardial infarction risk, whereas in those aged >60 years, the protective effect disappeared and reversed, indicating potential harm. These findings highlight the need for age-stratified secondary prevention strategies for AMI. Summary of Principal Study Outcomes.
A randomised controlled trial of a lived experience and education-based weight bias intervention for Australian healthcare students.
Jayawickrama RS, Hill B, Tran C … +4 more , O'Connor M, Flint SW, Hemmingsson E, Lawrence BJ
Int J Obes (Lond) · 2026 May · PMID 41764326 · Publisher ↗
BACKGROUND: A three-arm parallel randomised controlled trial was conducted to examine the efficacy of two brief videos for reducing healthcare students' explicit weight bias and to identify the key messages retained from...
BACKGROUND: A three-arm parallel randomised controlled trial was conducted to examine the efficacy of two brief videos for reducing healthcare students' explicit weight bias and to identify the key messages retained from the videos. METHODS: One hundred and three university students from 15 healthcare disciplines at 14 Australian universities viewed one of three randomly assigned brief videos: (1) empathy-focused (Experience), (2) education-focused (Science), or (3) smoking-focused (Control). Participants completed explicit weight bias measures at baseline, immediate post-intervention, and 2-week follow-up. Generalised linear mixed models (complete case and per-protocol) assessed intervention efficacy. Content analysis was used to examine participants' three main take-home messages from the videos. RESULTS: Per-protocol analysis showed improved clinical confidence in the Experience (vs. Control) Group (g = 0.79, p = 0.027) immediately post-intervention. Complete case analysis found immediate post-intervention improvements in the Science group for empathy (vs. Control, g = 0.74, p = 0.002; vs. Experience, g = 0.51, p = 0.039) and understanding of socioeconomic contributors to obesity (vs. Experience, g = 0.68, p = 0.005). Only the improved empathy for patients living with obesity in the Science (vs. Control, g = 0.49, p = 0.041) Group was sustained at follow-up. There were no significant differences immediately post-intervention or follow-up for the remaining outcomes. Content analysis revealed that students recognised the complexity of overweight and obesity, the existence and negative impact of weight bias within society and healthcare settings, and the need to use improved methods to reduce weight bias. CONCLUSION: The two brief weight bias videos had limited efficacy in reducing Australian healthcare students' explicit weight bias on most outcome measures, but improved students' empathy for patients and understanding of the socioeconomic contributors to obesity. Considerable reductions in explicit weight bias may require integrating weight bias reduction strategies into university curricula, with repeated exposure.
Organochlorine pesticides and obesity in a rural prediabetic population: exploring bidirectional pathways with metabolic indicators.
Shi J, Wei D, Ma C … +10 more , Geng J, Zhao M, Hou J, Huo W, Jing T, Chen Z, Huang S, Zeng X, Wang C, Mao Z
Int J Obes (Lond) · 2026 Jun · PMID 41760867 · Publisher ↗
OBJECTIVE: Given the potential of organochlorine pesticides (OCPs) to disrupt metabolic health, we aimed to explore their association with obesity and to explore the potential bidirectional mediating relationships involv...
OBJECTIVE: Given the potential of organochlorine pesticides (OCPs) to disrupt metabolic health, we aimed to explore their association with obesity and to explore the potential bidirectional mediating relationships involving metabolic health indicators among 894 rural Chinese adults with prediabetes. METHODS: A total of 894 individuals were included in this cross-sectional study. The associations of plasma OCPs on obesity and obese anthropometric measurements were assessed by generalized linear regression models for single exposure, and quantile g-computation (QGC) and LASSO regression for mixed exposure. The potential contributions of multiple health indicators to observed associations were assessed through mediation analysis. Exploratory bidirectional mediation analysis was employed to assess two potential pathways: (1) whether metabolic health indicators mediate the association between OCP exposure and obesity, and (2) whether obesity mediates the relationship between OCP exposure and metabolic health indicators. RESULTS: We discovered that β-Benzene hexachloride (β-BHC) and p,p'-Dichlorodiphenyldichloroethylene (p,p'-DDE) were related to obesity for single exposure. QGC and LASSO demonstrated that OCPs were positively correlated with a higher likelihood of obesity for mixed exposure, with β-BHC being the primary contributor. Exploratory mediation analysis found that obesity and metabolic-related indicators play a bidirectional mediating role in the association with OCPs, mainly involving systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein-Cholesterol (HDL-C), low-density lipoprotein-Cholesterol (LDL-C), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase/alanine aminotransferase (AST/ALT). CONCLUSIONS: In this cross-sectional study, we found that OCPs exposure may increase obesity risk both directly and by disrupting metabolism, while obesity itself can worsen OCP-related metabolic damage, revealing a bidirectional environment-body interaction.
Long-term outcomes of metabolic and bariatric surgery: a 10-year study of effectiveness and predictors.
Gonçalves J, Urbano Ferreira H, Menino J … +14 more , Meira I, Ribeiro S, Moreno T, Leite AR, Ferreira P, Costa T, Borges-Canha M, Pedro J, Varela A, Festas Silva D, Souto S, Freitas P, Lima da Costa E, Queirós J
Int J Obes (Lond) · 2026 May · PMID 41760866 · Publisher ↗
BACKGROUND/OBJECTIVES: This study aimed to evaluate long-term effectiveness of metabolic and bariatric surgery (MBS) over a 10-year period, to identify predictors of therapeutic success and weight loss, and to compare di...
BACKGROUND/OBJECTIVES: This study aimed to evaluate long-term effectiveness of metabolic and bariatric surgery (MBS) over a 10-year period, to identify predictors of therapeutic success and weight loss, and to compare differences between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). SUBJECTS/METHODS: A retrospective cohort study was conducted on patients who underwent MBS between 2010 and 2013 at a Portuguese tertiary hospital (n = 909). Patients who underwent laparoscopic adjustable gastric banding or revisional surgery during follow-up were excluded (n = 280). The 10-year loss to follow-up rate among included participants was 37.2% (n = 147). Clinical data were collected over a 10-year period. Therapeutic success was defined as a percentage excess weight loss (%EWL) of at least 50%. Multivariate logistic or linear regression analyses were performed to identify independent predictors of long-term outcomes. RESULTS: Of 395 participants included, 89.6% were females, with a mean age of 41.9 ± 10.8 years and a median body mass index (BMI) of 43.8 [40.9; 47.8]Kg/m; 88.1% underwent RYGB. After 10.0 ± 1.30 years, the mean weight loss was 31.0 ± 14.4 kg, corresponding to a percentage of total weight loss (%TWL) of 26.4 ± 11.0% and %EWL of 61.9 ± 26.6%. Therapeutic success was achieved by 70.6% of patients, and 39.0% lost at least 30.0% of baseline weight. Eighteen patients (4.55%) lost less than 5%. RYGB was associated with higher odds of long-term therapeutic success compared to SG (OR = 2.158 [95% CI 1.083-4.303], p = 0.029). Weight loss at one year also predicted long-term success (OR = 1.111 [95% CI 1.075-1.149], p < 0.001), while a higher BMI predicted lower %EWL (β = -1.684 [95% CI: -2.366 to -1.001], p < 0.001). CONCLUSION: MBS remains an effective long-term treatment for obesity, with RYGB offering superior outcomes compared to SG in our cohort. Our findings highlight the importance of early postoperative weight loss, and baseline BMI as key predictors of long-term outcomes and success after bariatric surgery.
Greater visceral fat mass accumulation with high alcohol consumption.
Chesters J, Neville MJ, Karpe F
Int J Obes (Lond) · 2026 Jun · PMID 41741675 · Full text
Regular alcohol consumption is commonly perceived to contribute to abdominal adiposity, particularly visceral fat mass (VFM). Observational studies in this area have either been small or used imprecise measurement method...
Regular alcohol consumption is commonly perceived to contribute to abdominal adiposity, particularly visceral fat mass (VFM). Observational studies in this area have either been small or used imprecise measurement methods of VFM (e.g., waist circumference). More precise methods, such as dual-energy x-ray absorptiometry (DXA), have not been used at scale to explore the association between alcohol consumption and VFM. We investigated the relationship between alcohol consumption and VFM in a population-based cohort of n = 5 761 men and women from the Oxford Biobank who underwent a DXA-scan and provided information on regular alcohol consumption using a structured questionnaire. After adjustment for key confounders - age, smoking, height, physical activity, socio-economic status, and total fat mass (TFM) - alcohol consumption remained dose-dependently associated with VFM, in males (ß = 1.104 (1.040-1.167), p < 0.001) and females (ß = 1.102 (1.029-1.180), p = 0.006). The mean VFM percentage (%VFM) in the highest alcohol consumption quartile was over 10% greater, relative to the mean %VFM in the adjacent lower quartile, in both males (median 24 vs 12 units/week) and females (median 14 vs 7 units/week). Elevated VFM among heavier drinkers may contribute to poorer cardiovascular and metabolic health and is relevant in the search for mechanisms of regional fat repositioning.
Adipocyte extracellular vesicles (AdEVs) promote a proinflammatory and profibrotic profile in human renal and endothelial cells in vitro.
Carrión P, Hernández MP, Pérez JA … +6 more , Tapia-Castillo A, Vecchiola A, Sandoval-Bórquez A, Baudrand RF, Fardella CE, Carvajal CA
Int J Obes (Lond) · 2026 May · PMID 41731023 · Publisher ↗
OBJECTIVES: In obesity, white adipose tissue (WAT) undergoes hypertrophic and hyperplastic changes that are driven by phenotypical changes in preadipocytes and adipocytes. WAT also causes a chronic inflammatory state tha...
OBJECTIVES: In obesity, white adipose tissue (WAT) undergoes hypertrophic and hyperplastic changes that are driven by phenotypical changes in preadipocytes and adipocytes. WAT also causes a chronic inflammatory state that modifies gene expression and the secretome, including the shedding of adipose-derived extracellular vesicles (AdEVs) into the circulation, which may influence distant cell types and modulate their phenotypes. AIM: To evaluate the effects of AdEVs on renal and endothelial cells and determine their impact on gene expression related to inflammation, fibrosis, and endothelial function. METHODS: Human SW872 preadipocytes were differentiated into adipocytes and subsequently characterized. AdEVs were isolated by ultracentrifugation and analyzed according to ISEV guidelines. Recipient human renal (HCD) and endothelial (EA.hy926) cells were exposed to AdEVs for 24 hours. Gene expression of adipokines, cytokines (IL-6, IL-1B), fibrosis markers, neutrophil gelatinase-associated lipocalin (NGAL), and eNOS was assessed by RT-qPCR and western blotting. RESULTS: Differentiated SW872 cells displayed typical adipocyte morphology and accumulated abundant lipid droplets. Isolated AdEVs showed a donut-like morphology, characteristic size distribution, and expression of CD9 and TSG101, consistent with canonical EV markers. Both renal and endothelial cells internalized PKH67-labeled AdEVs and exhibited increased IL-6 and IL-1B expression (p < 0.05). Renal cells demonstrated increased NGAL mRNA levels, whereas endothelial cells showed reduced eNOS mRNA expression following AdEV exposure (p < 0.05). CONCLUSION: AdEVs from SW872 upregulated cytokine (e.g., IL-6) and NGAL expression in renal cells, while reducing eNOS expression in endothelial cells. These findings suggest that AdEVs may influence early inflammatory and vascular responses in obesity.
Efficacy of GLP-1 analog peptides, semaglutide, tirzepatide, and retatrutide on MC4R deficient obesity and their comparison.
Hitaka K, Sugawara T, Matsumoto M … +1 more , Nio Y
Int J Obes (Lond) · 2026 Apr · PMID 41723268 · Full text
INTRODUCTION: Melanocortin 4 receptor (MC4R) is a G-protein-coupled receptor expressed in the hypothalamus, playing a key role in regulating feeding behavior and energy homeostasis. MC4R is integral to the POMC-MC4R and...
INTRODUCTION: Melanocortin 4 receptor (MC4R) is a G-protein-coupled receptor expressed in the hypothalamus, playing a key role in regulating feeding behavior and energy homeostasis. MC4R is integral to the POMC-MC4R and leptin-MC4R pathways, which control food intake and body weight. Mutations in the POMC gene lead to severe early-onset obesity and increased food consumption. Recently, glucagon-like peptide-1 (GLP-1) analogs, including semaglutide, tirzepatide, and retatrutide, have been explored as potential anti-obesity therapies. METHODS: This study aimed to assess and compare the efficacy of these GLP-1 analogs in MC4R knockout (KO) mice, which are deficient in the POMC-MC4R pathway. GLP-1 analogs were administered for 21 days to MC4R KO mice and compared their efficacy. RESULTS: The percentage of body weight reduction was 19.7 ± 4.1% for semaglutide, 31.6 ± 7.6% for tirzepatide, and 24.1 ± 5.8% for retatrutide. Body composition analysis, including fat and lean mass, was performed using the Echo-MRI system, revealing significant suppression of both fat and lean mass by all three GLP-1 analogs. Furthermore, GLP-1 analogs improved plasma insulin levels, HOMA-IR, cholesterol levels, and markers of liver damage (AST and ALT), as well as reduced liver hypertrophy. While GLP-1 analogs suppressed genes related to fatty acid synthesis, they had no significant effect on inflammation-related gene expressions. Additionally, GLP-1 analogs reduced energy expenditure, with only tirzepatide showing a significant decrease in the respiratory quotient (RQ) in MC4R KO mice. CONCLUSION: Our findings demonstrate that all three GLP-1 analogs, semaglutide, tirzepatide, and retatrutide, exhibit significant anti-obesity effects in MC4R KO mice. These results suggest that GLP-1 analogs may provide an effective treatment option for patients with MC4R-POMC pathway deficiencies. Moreover, the efficacy of these drugs in MC4R KO mice aligns with clinical studies, indicating that MC4R KO mice serve as a reliable animal model for obesity research.
Anthropometric percentiles for Peruvian adults: population reference curves for body mass index, waist circumference, and waist-to-height ratio.
Vera-Ponce VJ, Ballena-Caicedo J, Valladolid-Sandoval LAM … +4 more , Zuzunaga-Montoya FE, Poemape Mestanza RL, Garavito Castillo MF, Gutierrez De Carrillo CI
Int J Obes (Lond) · 2026 May · PMID 41720916 · Full text
INTRODUCTION: Current anthropometric cut-off points for defining overweight, obesity, and abdominal obesity are based on predominantly Caucasian populations, raising questions about their applicability in ethnically and...
INTRODUCTION: Current anthropometric cut-off points for defining overweight, obesity, and abdominal obesity are based on predominantly Caucasian populations, raising questions about their applicability in ethnically and geographically diverse populations such as the Peruvian population. The lack of population-specific references limits the appropriate assessment of anthropometric distributions and cardiometabolic risk in Peruvian adults. OBJECTIVE: To develop body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) percentile curves specific for the Peruvian adult population, stratified by age and sex. METHODS: Analytical cross-sectional study based on data from the Demographic and Family Health Survey (DHS) 2015 to 2023. From an initial sample of 385,247 adults aged 20-97 years, 164,513 participants with complete anthropometric measurements and plausible values were included in the final analysis. Percentiles (P5, P10, P25, P50, P75, P85, P90, P95, P97) were calculated using the LMS (Lambda-Mu-Sigma) method for BMI, WC, and WHtR by five-year age groups and sex. RESULTS: The final sample included 164,513 participants (48.52% women, 51.48% men) with a mean (±standard deviation, SD) age of 44.38 ± 16.72 years. Mean BMI was 27.77 ± 4.80 kg/m². The prevalence of overweight was 42.16% and obesity 28.09% according to BMI criteria. Abdominal obesity varied dramatically according to the criterion used: 44.75% (ATP III) versus 68.31% (IDF) for WC, highlighting the problem of universal cut-off points. Sex-specific percentiles showed distinctive age patterns with increases until middle age followed by gradual decline. Altitude differences were clinically significant: 2.5-3.0 kg/m² for BMI, 4-6 cm for WC, and 0.04-0.06 units for WHtR between sea level versus high altitude (≥3000 m). CONCLUSIONS: Age- and sex-specific anthropometric percentiles reveal distinctive age patterns that differ substantially from international cut-off points. Classical criteria for abdominal obesity (ATP III, IDF) and WHtR (≥0.5) systematically overestimate prevalence in the Peruvian population, with discrepancies reaching differences of up to 23.5 percentage points between criteria. Altitude differences are clinically significant, suggesting specific physiological adaptations in Andean populations.
Genetic determinants of BMI, diet, and fitness interact to partially explain anthropometric obesity traits but not the metabolic consequences of obesity in men and women.
Arrington CE, Tacad DKM, Allayee H … +5 more , Sutton KJ, Dombroski C, Keim NL, Newman JW, Bennett BJ
Int J Obes (Lond) · 2026 Apr · PMID 41720915 · Full text
BACKGROUND: Understanding how genetic factors interact with diet and lifestyle to influence obesity is critical as we move towards models of precision nutrition and medicine. OBJECTIVES: To assess how genetic and lifesty...
BACKGROUND: Understanding how genetic factors interact with diet and lifestyle to influence obesity is critical as we move towards models of precision nutrition and medicine. OBJECTIVES: To assess how genetic and lifestyle factors influence the variation in body composition and metabolic syndrome (Metsyn) risk factors. METHODS: A cross-sectional sample of age/sex/BMI-balanced 18-66 year old men and women (n = 211) from the USDA Nutritional Phenotyping Study were included in the analysis (NCT02367287). BMI polygenic risk scores (PRS) were calculated with the pgs_calc pipeline. Associations with body composition and Metsyn traits were assessed by linear regression and ANCOVA. Explained variance was evaluated using sum of squares and partial R², with model constraint using Bayesian information criteria. RESULTS: The PRS independently explained 15.6% of BMI variance and, after adjusting for age, sex, and genetic population structure, accounted for 11.3% of BMI variance (p = 1.1 × 10⁻⁷). Measures of diet quality, fitness, and resting metabolic rate (RMR) showed mixed independent associations with obesity traits. In best fit models, while the PRS was significant for DXA outcomes, waist circumference, and fasting TG, the explained variance was below 3% except in android-to-gynoid ratio (3.3%), lean mass index (6.6%), and waist circumference (10.1%). The BMI PRS showed subtle associations with the metabolic/physiological consequences of obesity, only waist circumference and plasma glucose were associated with PRS. Blood pressure, triglycerides, and HDL levels were not associated with PRS for obesity. CONCLUSIONS: The genetic factors influencing BMI appear to differ from those contributing to measures of adiposity and metabolic consequences of obesity. Genetic risk of high BMI was validated in this cohort, but sex, RMR, and fitness are the more refined determinants of adiposity and dysregulated metabolism in this healthy population. Future research should be sure to utilize genetic risk predictors specifically associated with maladaptive obesity traits rather than more broad associated phenotypes. CLINICAL TRIAL REGISTRY: NCT02367287.
Relationship between the microbiome and obesity-associated cancer risk using Mendelian randomisation.
Yates T, Went M, Mills C … +2 more , Law P, Houlston R
Int J Obes (Lond) · 2026 Jun · PMID 41714395 · Full text
BACKGROUND: The mechanisms underlying obesity-related cancer risk are incompletely understood. We investigated whether the gut microbiome causally mediates this relationship. METHODS: We performed two-sample Mendelian ra...
BACKGROUND: The mechanisms underlying obesity-related cancer risk are incompletely understood. We investigated whether the gut microbiome causally mediates this relationship. METHODS: We performed two-sample Mendelian randomisation, with mediation analysis, to assess causal links between genetically predicted body mass index (BMI)/waist-to-hip ratio adjusted for BMI (WHRadjBMI), 211 gut microbial taxa, and eight cancers (384,738 cases) of European ancestry. Significant associations were replicated in the FinnGen cohort. RESULTS: Genetically predicted BMI was associated with risk of colorectal (CRC; odds ratio per standard deviation (OR): 1.12; 95% confidence interval (CI): [1.06-1.17]; P = 4.95 × 10), kidney (RCC) (OR: 1.48; 95% CI: [1.34-1.63]; P = 1.61 × 10), endometrial (OR: 1.70; 95% CI: [1.55-1.87]; P = 2.09 × 10), lung (OR: 1.20; 95% CI: [1.12-1.29]; P = 1.40 × 10), and oesophageal cancer (OR: 1.25; 95% CI: [1.13-1.39]; P = 3.09 × 10). Seven microbial taxa were associated with CRC risk. Phylum and class Actinobacteria showed the strongest effects (OR: 1.48; 95% CI: [1.29-1.70]; P = 1.78 × 10) and (OR: 1.36; 95% CI: [1.22-1.51]; P = 2.57 × 10), respectively, and replicated in FinnGen, mediating 29% (95% CI: [8-50]) and 21% (95% CI: [4-37]) of the BMI to CRC risk-collectively accounting for 50% of the relationship. No consistent microbiome mediation was observed for other cancers. CONCLUSIONS: Gut Actinobacteria may contribute to obesity-driven CRC risk, supporting the rationale of microbiome-targeted interventions to reduce CRC risk.
The anti-obesity effect of namodenoson, an A3 adenosine receptor agonist.
Fishman P, Itzhak I, Safadi R … +3 more , Amer J, Salhab A, Bareket-Samish A
Int J Obes (Lond) · 2026 Apr · PMID 41692913 · Full text
Namodenoson-a selective A3 adenosine receptor (A3AR) agonist-is currently in clinical trials for hepatocellular carcinoma and metabolic dysfunction-associated steatotic liver disease. This preclinical study investigated...
Namodenoson-a selective A3 adenosine receptor (A3AR) agonist-is currently in clinical trials for hepatocellular carcinoma and metabolic dysfunction-associated steatotic liver disease. This preclinical study investigated its potential utility as a weight-loss drug. In 3T3-L1 adipocyte cells, namodenoson exhibited a dose-dependent inhibitory effect on the proliferation and accumulation of lipid droplets. Compared to vehicle, 5 and 10 nM of namodenoson inhibited adipocyte proliferation (determined using H-thymidine incorporation assay) by 26 ± 12% (P < 0.05) and 54 ± 5% (P < 0.001), respectively, and lipid accumulation (determined by Oil-Red-O staining) by 22 ± 8% (P < 0.05) and 41 ± 9% (P < 0.001), respectively. Western blot analyses using 3T3-L1 adipocyte cells demonstrated that namodenoson led to downregulation of A3AR, PPARγ, C/EBPα, C/EBPβ, p-AKT, PI3K, NF-kB, and β-catenin, and upregulation of adiponectin. In-vivo experiments in a murine model of diet-induced obesity demonstrated that administering daily namodenoson (100 μg/kg) to high-fat-fed mice led to a significant difference in weight after 4 weeks of treatment compared to high-fat-fed mice without namodenoson (44.3 ± 2.2 vs 47.2 ± 3.4 g, respectively, P = 0.001), representing a difference in weight of 6.1%. The same experiment on mice fed a lean diet demonstrated no namodenoson effect (mean weight: 33.5 ± 3.9 vs 33.0 ± 0.6 g, respectively). In conclusion, our findings support continued investigation of namodenoson as a weight-loss drug candidate.
Weight stigma among diverse ethnic groups with obesity in the U.S.: the USA-OBESTIGMA study.
Galindo RJ, Arevalo G, Zabala Z … +6 more , Flores I, Soliman D, Moazzami B, Rashied A, Lecube A, Umpierrez GE
Int J Obes (Lond) · 2026 May · PMID 41688783 · Full text
BACKGROUND: The evidence on weight-related stigmatization among U.S. Hispanic (HISP), non-Hispanic White (NHW), and non-Hispanic Black (NHB) adults with obesity is limited. We compare levels of prejudices, stigma, and in...
BACKGROUND: The evidence on weight-related stigmatization among U.S. Hispanic (HISP), non-Hispanic White (NHW), and non-Hispanic Black (NHB) adults with obesity is limited. We compare levels of prejudices, stigma, and internalization of negative bias across diverse minority groups using validated surveys. METHODS: Observational study conducted at two academic centers, including adults ( ≥ 18 years of age) with body mass index (BMI) ≥ 30 kg/m. We assessed 1) weight-related aversion/prejudices using Anti-Fat Attitudes (AFA) survey, 2) stigmatizing experiences with the Brief Stigmatizing Situations Inventory (SSI-B), and 3) internalization of negative weight bias with the Weight Bias Internalization Scale (WBIS) survey. RESULTS: Among 296 participants (age 54.9 ± 13 years, 59% females, 42% HISP, 23% NHW, 35% NHB), with obesity (BMI 36.7 ± 6.2), 72% perceived themselves as having overweight and only 24% as having obesity. Among the three groups, HISP had the highest AFA score (3.6 ± 1.3 vs. 3.3 ± 1.1 vs. 2.1 ± 1.2, p < 0.001), NHW had the highest SSI-B (1.2 ± 1.1 vs. 2.0 ± 1.4 vs. 1.2 ± 1.4, p < 0.001), and NHB had the lowest WBIS (2.7 ± 1.2 vs. 3.0 ± 1.3 vs. 2.3 ± 1.2, p < 0.001) score. CONCLUSIONS: Among an ethnically diverse U.S. cohort of adults with obesity, most participants perceive themselves as having overweight and not obesity. HISP exhibited greater aversion and prejudices towards people with obesity, NHW reported more stigmatizing situations and NHB the lowest internalization of negative bias. These findings should be incorporated when developing or implementing culturally appropriate educational or interventional programs for people with obesity.
Adherence to positive airway pressure therapy and healthcare resource utilization and costs among patients with obstructive sleep apnea and obesity.
Sert Kuniyoshi FH, Cameron A, Pépin JL … +7 more , Dexter RB, Woodford C, Cistulli PA, Alpert N, Sterling KL, Malhotra A, medXcloud group
Int J Obes (Lond) · 2026 Apr · PMID 41680491 · Full text
OBJECTIVE: Obstructive sleep apnea (OSA) and obesity are highly prevalent comorbid conditions associated with major societal and healthcare burden. Positive airway pressure (PAP) therapy is the first-line treatment for O...
OBJECTIVE: Obstructive sleep apnea (OSA) and obesity are highly prevalent comorbid conditions associated with major societal and healthcare burden. Positive airway pressure (PAP) therapy is the first-line treatment for OSA. This study evaluated the association between PAP adherence and healthcare resource utilization (HCRU) and costs in patients with OSA and comorbid obesity. METHODS: This retrospective cohort study utilized de-identified claims data linked with cloud-connected PAP usage to analyze adults with obesity (ICD-10 code of obesity or morbid obesity or indicating BMI ≥ 30 kg/m) newly diagnosed with OSA who initiated PAP between 2015 and 2021. Patients were categorized based on adherence: adherent (met Medicare criteria for all quarters), intermediate (adherent for at least one quarter), or nonadherent. Primary outcomes included all-cause emergency room (ER) visits and hospitalizations. Healthcare costs, including inpatient, ER, and total costs, were secondary outcomes. Inverse probability of treatment weighting was applied to balance baseline characteristics across adherence groups. RESULTS: Among 173,691 patients, 35.2% were adherent, 39.1% intermediately adherent, and 25.7% nonadherent. After applying inverse probability of treatment weighting (IPTW), in year 1 post-index, adherent patients had significantly fewer ER visits and hospitalizations (0.55 ± 1.77 and 0.10 ± 0.44) compared to nonadherent patients (0.69 ± 1.78 and 0.14 ± 0.56; P < 0.001), and significantly lower total healthcare costs (11,332 ± 21,160 vs 11,927 ± 20,212; P < 0.001). Similar findings were observed after 2 years of therapy with adherent patients having lower HCRU and costs than nonadherent patients. Patients with intermediate adherence had outcomes between those of adherent and nonadherent groups, suggesting a dose-dependent effect. CONCLUSIONS: Greater adherence to PAP therapy is associated with significantly lower HCRU and costs in patients with OSA and obesity, highlighting the importance of implementing strategies to improve long term PAP adherence, potentially reducing economic and clinical burden.
Love and compassion: key ingredients in the treatment of obesity.
Chaput JP
Int J Obes (Lond) · 2026 May · PMID 41680490 · Publisher ↗
Obesity management has traditionally focused on diet, physical activity, and medical interventions, while emotional and relational factors such as compassion, connection, and the reduction of shame remain underemphasized...
Obesity management has traditionally focused on diet, physical activity, and medical interventions, while emotional and relational factors such as compassion, connection, and the reduction of shame remain underemphasized. Emerging evidence highlights the roles of love and compassion-defined as care, connection, and kindness toward oneself and others-as potential catalysts for sustainable lifestyle change. Compassion-based approaches reduce shame, stigma, and emotional dysregulation, thereby supporting self-care and motivation. This Perspective advances the view that integrating love and compassion into obesity treatment offers a more humane and potentially more effective framework for improving health and well-being among individuals living with obesity.
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