International Journal Of Obesity (2005)[JOURNAL]
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200 papers
The Physiology Of the WEight Reduced State (POWERS) study: design and rationale for assessment of food intake, physical activity and other behavioral constructs.
Mayer LES, Lowe M, Allison KC … +17 more , Ashby-Thompson M, Benasi G, Burger KS, Fielding RA, Foerde K, Gallagher D, Jakicic JM, Hayes MR, Kline CE, Laughlin MR, Roberts SB, St-Onge MP, Whyte KJ, Yanovski SZ, Young-Hyman D, King WC, POWERS Consortium
Int J Obes (Lond) · 2026 Jan · PMID 41514047 · Publisher ↗
The Physiology Of the WEight Reduced State (POWERS) study is a multi-center NIH-funded clinical trial designed to determine the physiological basis for variability in weight loss maintenance among adults with obesity fol...
The Physiology Of the WEight Reduced State (POWERS) study is a multi-center NIH-funded clinical trial designed to determine the physiological basis for variability in weight loss maintenance among adults with obesity following participation in a behavioral weight loss program. Two hundred and five healthy adults, aged 25-<60 years, with body mass index 30-<40 kg/m complete up to four serial assessments (before weight loss; after ≥7% weight loss; and four and 12 months later). This report, one in a five-part series on the POWERS study design, provides the rationale for and description of behavioral measures. Standardized laboratory meals are used to measure energy intake and eating-related behaviors. Behavioral and neurocognitive factors related to eating (e.g., food-choice decision making, taste preferences, reward, self-control) are assessed via computer-based tasks and self-report questionnaires. Functional and structural neuroimaging augment the behavioral assessments by identifying underlying neural circuitry. Psychological factors related to weight regulation (e.g., self-monitoring, stigma, self-efficacy) are assessed via self-report questionnaires. Free-living physical activity and sleep are measured via accelerometry, polysomnography and self-report questionnaires. We will evaluate how changes, integrated values and patterns in these predictors and components of energy intake and energy expenditure contribute to individual variability in weight change during the 12 months following weight loss. We anticipate that extensive phenotyping using sophisticated eating behavior paradigms and assessments of critical components of energy expenditure before and after weight loss will lead to improved predictions of successful weight loss maintenance. This, in turn, will inform more effective treatments for long-term sustained weight loss.
Brown adipose tissue-derived exosomes ameliorate obesity-related hypertension via HuR-mediated restoration of endothelial function.
Hu X, Li H, Dou Y … +7 more , Lv Z, Zhang Y, Zou T, Tang R, Wang H, Abudula A, Malasadi N
Int J Obes (Lond) · 2026 Apr · PMID 41514046 · Publisher ↗
BACKGROUND: Obesity-related hypertension (OH) is driven by endothelial dysfunction, chronic inflammation, and oxidative stress, yet effective targeted therapies are lacking. This study aims to investigate the mechanisms...
BACKGROUND: Obesity-related hypertension (OH) is driven by endothelial dysfunction, chronic inflammation, and oxidative stress, yet effective targeted therapies are lacking. This study aims to investigate the mechanisms by which brown adipose tissue-derived exosomes (BAT-Exos) improve vascular endothelial function in OH via HuR protein delivery. METHODS: Rat models with OH and palmitic acid-treated endothelial cell injury models were established. BAT-Exos were compared with white adipose tissue-derived exosomes (WAT-Exos) for therapeutic efficacy. In vitro, primary endothelial cells isolated from rat aortas were treated with palmitic acid to induce injury, followed by pre-treatment with BAT-Exos or WAT-Exos. Inflammatory cytokines, adhesion molecules, oxidative stress markers, eNOS activity, and nitric oxide (NO) levels were measured. RESULTS: BAT-Exos exert superior therapeutic effects compared to WAT-Exos in both in vivo and in vitro models of OH. In rat model of high-fat-diet-induced OH, BAT-Exos improved metabolic profiles, lowered blood pressure, and alleviated vascular remodeling, while reducing inflammation and restoring eNOS activity. In vitro, BAT-Exos significantly mitigated palmitic acid-induced endothelial dysfunction by suppressing pro-inflammatory cytokines, adhesion molecules, and oxidative stress markers, while enhancing nitric oxide production. CONCLUSION: These findings confirm HuR as a key therapeutic cargo. The BAT-Exo-HuR axis represents a novel intercellular signaling pathway that improves vascular function and may serve as a promising strategy for treating OH and related cardiovascular disorders.
Estimating the effect of hypothetical dietary protein interventions on changes in body composition of postmenopausal women over 3 years using data from the Women's Health Initiative (WHI) Study: an emulated target trial.
Li J, Jiang L, Saquib N … +9 more , Gradidge PJ, Liu S, Van Horn L, Richey PA, Timberlake DS, Beydoun HA, Liu L, Li J, Odegaard AO
Int J Obes (Lond) · 2026 Mar · PMID 41514045 · Full text
BACKGROUND: Postmenopausal women tend to experience significant changes in body composition, particularly abdominal adipose tissue (AAT) deposition patterns, which are hypothesized to be critical factors influencing futu...
BACKGROUND: Postmenopausal women tend to experience significant changes in body composition, particularly abdominal adipose tissue (AAT) deposition patterns, which are hypothesized to be critical factors influencing future chronic disease risk. The level of protein intake to maintain or achieve a more favorable body composition for health in postmenopausal women is a central, largely unanswered question relating to the appropriateness of current dietary guideline recommendations for sufficient protein intake (set at 0.8 g/kg/day). OBJECTIVE: To estimate the hypothetical effect of a range of protein intake levels on 3-year mean changes in body composition measures in postmenopausal women. METHODS: We analyzed data from 3789 postmenopausal women aged 50-79 enrolled in the Women's Health Initiative (WHI) to emulate a 3-year target trial of adhering to increasing levels of protein intake: ≥0.8 g/kg/d, ≥1.0 g/kg/d, ≥1.2 g/kg/d, and ≥1.5 g/kg/d. All participants had repeated Dual X-Ray Absorptiometry (DXA) scans with derived abdominal visceral (VAT) and subcutaneous adipose tissue (SAT). The measured differences in average levels of VAT, SAT, and other body composition measures determined at end of follow-up were estimated with the parametric-g formula. RESULTS: Over 3 years, hypothetical interventions of increasing levels of dietary protein intake are estimated to have dose-dependent reductions in abdominal VAT, SAT, and overall body fat, and increases in lean soft tissue, with potential benefits observed at ≥1.2 g/kg/day and the greatest estimated benefit at ≥1.5 g/kg/day of dietary protein. Compared to no intervention, if all participants hypothetically adhered to a total daily protein intake of ≥1.5 g/kg/day over 3 years, they would be estimated to have lower levels of VAT (-13.1 cm, 95% Confidence Interval [CI] -18.9, -7.3), SAT (-25.3 cm, 95% CI -39.7, -11.0), total body fat % (-1.0%, 95% CI -1.7, -0.3), body weight (-2.5 kg, 95% CI -3.7, -1.2) and greater lean soft tissue % (0.9%, 95% CI 0.3, 1.6) over 3 years. CONCLUSION: This hypothetical emulated intervention suggests that postmenopausal women who maintain a hypothetical total protein intake of at least 1.2 g/kg/day could experience beneficial changes in abdominal VAT, SAT, and overall body composition over three years, with even greater estimated benefits observed at an intake of 1.5 g/kg/day. These findings suggest that protein intake higher than guideline recommendations may better support healthier body composition and lower chronic disease risk in postmenopausal women.
Metabolic syndrome in Australia: nationwide survey results by remoteness and Indigenous status, 2012-2019.
Mondal UK, Huda MM, Anyasodor AE … +10 more , Pak SC, Kalinna BH, Astawesegn FH, Thapa S, Ahmed KY, Aychiluhm SB, Mahmood S, Rahman MF, Shiddiky MJA, Ross AG
Int J Obes (Lond) · 2026 Apr · PMID 41507614 · Full text
BACKGROUND: In Australia, the rising prevalence of metabolic syndrome (MetS) presents a significant public health challenge. However, research on geographic and ethnic disparities remains limited. This study aimed to inv...
BACKGROUND: In Australia, the rising prevalence of metabolic syndrome (MetS) presents a significant public health challenge. However, research on geographic and ethnic disparities remains limited. This study aimed to investigate the prevalence and temporal trends of MetS by geographic remoteness and between Indigenous and non-Indigenous Australians. METHODS: We analysed data from 44,760 adults (aged ≥18 years) derived from the National Health Survey (2014-2015 and 2017-2018) and the National Aboriginal and Torres Strait Islander Health Survey (2012-2013 and 2018-2019). Weighted prevalence estimates of MetS were calculated overall and stratified by remoteness. The Average Annual Rate of Change (AARC) in MetS prevalence was computed to assess temporal trends. RESULTS: MetS prevalence varied notably by remoteness and ethnicity. In the most recent surveys, 7.1% (95% CI: 6.19-8.19) of Indigenous adults (2018-2019) and 4.6% (95% CI: 4.23-4.99) of non-Indigenous adults (2017-2018) had MetS. Prevalence was higher in remote areas for both groups. Among non-Indigenous adults, MetS declined across most regions but increased in remote areas from 4.5% to 7.1% (AARC: +15.77%), while among Indigenous adults it remained stable in remote areas but rose in major cities and regional settings. Central obesity and type 2 diabetes (T2D) were the most prominent contributors to MetS among Indigenous adults, whereas hypertension and high cholesterol were more prevalent among non-Indigenous adults in regional areas. Central obesity was the most common MetS risk factor, affecting 57.4% (95% CI: 55.14-59.63) of Indigenous and 40.9% (95% CI: 39.90-41.85) of non-Indigenous adults. High cholesterol was the least common risk factor among Indigenous adults (7.6% [95% CI: 6.58-8.67]), whereas elevated blood sugar was the least common among non-Indigenous adults (4.8% [95% CI: 4.44-5.21]). CONCLUSIONS: Substantial disparities in MetS exist across Australia, disproportionately affecting Indigenous Australians and residents of remote areas. Culturally tailored, region-specific interventions targeting obesity are urgently needed through Local Health Districts and Aboriginal Community Controlled Health Organisations.
Body composition references, sarcopenia cutoffs, and prevalence in youth using bioelectrical impedance analysis.
Song K, Lee E, Lee HS … +4 more , Lee H, Kim JY, Choi Y, Chae HW
Int J Obes (Lond) · 2026 Feb · PMID 41507613 · Publisher ↗
BACKGROUND/OBJECTIVES: Reference data for bioelectrical impedance analysis (BIA) parameters remain limited in youth, making sarcopenia assessment challenging. This study aimed to establish BIA reference values and determ...
BACKGROUND/OBJECTIVES: Reference data for bioelectrical impedance analysis (BIA) parameters remain limited in youth, making sarcopenia assessment challenging. This study aimed to establish BIA reference values and determine sarcopenia cutoff points and prevalence in youth. SUBJECTS/METHODS: This cross-sectional study analyzed 1451 youth aged 10-25 years who underwent BIA using data from a nationwide survey. Reference values for body composition were established using the least mean squares method, which estimates age-specific percentiles. Sarcopenia was defined using skeletal muscle mass index (SMI), fat-free mass-to-fat ratio (FFM-MFR), and appendicular skeletal muscle mass-to-fat ratio (ASM-MFR) with age- and sex-specific cutoff values. RESULTS: Muscle-related parameters, including fat-free mass, fat-free mass index, ASM, and SMI, increased during puberty in both sexes, with a more pronounced increase in males, followed by a plateau or gradual increase after adolescence. Fat-related parameters, including fat mass, fat mass index, and percentage body fat, decreased until age 14 years in males before increasing, whereas in females, they increased until adolescence and declined after early adulthood. The prevalence of sarcopenia was 2.05% in males and 1.04% in females based on SMI, 5.21% in males and 6.38% in females based on FFM-MFR, and 5.06% in males and 5.79% in females based on ASM-MFR. CONCLUSIONS: This study established BIA-based body composition reference values for youth using nationally representative data, identified age- and sex-specific sarcopenia cutoff points and prevalence estimates, and highlighted age- and sex-specific differences. These findings provide a valuable resource for the early identification and management of sarcopenia in youth.
Comprehensive cognitive training improves anthropometric measures in people with excess weight: the TRAINEP randomized controlled trial.
Solier-López L, González-González R, Caracuel A … +3 more , Verdejo-García A, Puertas-González JA, Vilar-López R
Int J Obes (Lond) · 2026 Apr · PMID 41501174 · Publisher ↗
OBJECTIVE: To evaluate the efficacy of a comprehensive cognitive intervention as an add-on to a standard behavioral weight-loss intervention (BWLI) in improving anthropometric measures in individuals with excess weight....
OBJECTIVE: To evaluate the efficacy of a comprehensive cognitive intervention as an add-on to a standard behavioral weight-loss intervention (BWLI) in improving anthropometric measures in individuals with excess weight. PARTICIPANTS: This randomized controlled trial included 148 participants (126 women; mean BMI = 31.62 kg/m²); 86.5% participants (n = 128) completed the study. METHODS: Participants were randomized into three groups: (1) Cognitive group (received four cognitive trainings: inhibitory control, approach-avoidance bias modification, implementation intentions, and episodic future thinking); (2) Sham group (received placebo cognitive interventions); and (3) Control group (no cognitive intervention). All three groups received BWLI. Cognitive trainings were delivered through four consecutive 90-min online group sessions. BMI, weight, percentage of weight loss (%WL), and waist-to-height ratio (WHtR) were assessed at baseline, post-treatment, and 3- and 6-month follow-ups. Mixed 3 (group) × 3 (time point) analysis were conducted to examine changes over time and between groups. Chi-squared test was used to explore group differences in reaching a clinically meaningful %WL. RESULTS: Significant group-by-time effects interactions were found for BMI (p = 0.009), weight (p = 0.003), %WL (p = 0.004) and WHtR (p = 0.041). Post hoc analyses showed greater reductions in all anthropometric measures in the Cognitive group compared to the Control group at post-intervention and at both follow-ups. Further, only the Cognitive group showed significant improvements over time. At 6-month follow-up, effect sizes were moderate in the Cognitive group, small in the Sham group, and negligible to small in the Control group. A higher proportion of participants in the Cognitive group achieved a clinically meaningful %WL. CONCLUSIONS: A comprehensive cognitive training delivered as an add-on to BWLI improved anthropometric outcomes in individuals with excess weight, with sustained effects over 6 months.
Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to understand how obesity risk varies according to multiple lifestyle behavior recommendations.
Swain A, Pearson N, Willis SA … +1 more , Johnson W
Int J Obes (Lond) · 2026 Apr · PMID 41501173 · Full text
BACKGROUND: The combined and interactive effects of multiple lifestyle behaviours on obesity risk are not well understood. We used Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to e...
BACKGROUND: The combined and interactive effects of multiple lifestyle behaviours on obesity risk are not well understood. We used Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to examine how adherence to public health recommendations for five lifestyle behaviours affects BMI and obesity risk. METHODS: The sample included 139,540 men and 125,455 women from the UK Biobank. We categorized fruit and vegetable intake, physical activity, sleep duration and alcohol intake as binary variables (meeting vs. not meeting guidelines), and smoking status into three categories (previous, current, never). These categories were combined to form 48 unique strata, representing all possible combinations of the five behaviours. Linear and binary logistic MAIHDA models were used, with individuals nested within strata, and BMI and obesity status (obesity vs. normal weight) as outcomes. Three models were employed: Model 1 (null), Model 2 (with fixed effects for lifestyle behaviours), and Model 3 (with confounders and fixed effects). Variance Partition Coefficient (VPC), Proportional Change in Variance (PCV), and predicted BMI and obesity risk were estimated. RESULTS: For both sexes, strata with the lowest obesity risk were associated with meeting most recommendations, while strata with the highest risk were linked to meeting few. Logistic Model 1 VPCs revealed 7% of variance in obesity risk among males and 5% among females was explained by between-strata differences. In Model 3, VPCs attenuated to 0.5% among males and 0.1% among females, suggesting differences in obesity risk were largely additive effects. PCVs from Model 3 also indicated primarily additive rather than interactive effects. Results were similar for BMI in the linear models. CONCLUSIONS: Using a novel statistical approach, this study shows that additive effects of multiple lifestyle behaviours predominantly explain differences in BMI and obesity risk. Meeting more public health lifestyle recommendations is important in mitigating obesity risk.
Canagliflozin regulates adipocyte lipolysis in vitro via a SGLT2 independent signaling pathway.
Li Q, Li M, Zhou J … +6 more , Huang J, Xu X, Zhang Z, Jiang L, Huang Y, Yang X
Int J Obes (Lond) · 2026 Apr · PMID 41495449 · Publisher ↗
BACKGROUND: Adipose lipolysis, a process involving the degradation of triglycerides and the release of fatty acids and glycerol, is an important biological event in lipid metabolism. Canagliflozin (Cana), an oral antidia...
BACKGROUND: Adipose lipolysis, a process involving the degradation of triglycerides and the release of fatty acids and glycerol, is an important biological event in lipid metabolism. Canagliflozin (Cana), an oral antidiabetic drug, regulates blood glucose by inhibiting sodium-glucose cotransporter 2 (SGLT2) in renal tubules and has also been shown to improve lipid metabolism in adipocytes. This study aims to determine whether Cana directly affects adipose lipolysis and to explore the underlying mechanistic pathways. METHOD: Primary mature adipocytes and differentiated preadipocytes isolated from the epididymal fat pads of Sprague-Dawley rats were used as in vitro models. The effects of Cana on glycerol release and lipase activity were evaluated using ELISA and Western blot analyses. RESULTS: Cana treatment directly inhibited basal glycerol release and lipase activity in both primary adipocytes and topically administered adipose tissue, achieving a dose-dependent 35% to 65% suppression of lipolysis. This was associated with a 2.3-fold decrease in the level of HSL phosphorylated at the Ser660 site. Using differentiated adipocytes derived from the human Simpson-Golabi-Behmel syndrome (SGBS) pre-adipocyte cell line, we found that Cana significantly attenuated glycerol release (~32% to 53% reductions) induced by lipolysis. Moreover, Cana exerted antilipolytic effects in models of both acute (isoprenaline-induced) and chronic (tumor necrosis factor-α-induced) lipolysis. Mechanistically, the antilipolytic effect of Cana was mediated through activation of the PI3K/AKT pathway and reduction of cAMP production. CONCLUSION: In conclusion, Cana regulates adipocyte lipolysis via an SGLT2-independent signaling pathway, which enhances our understanding of its role in modulating lipid metabolism.
Greater early postprandial GLP-1 increase after Roux-en-Y than one-anastomosis gastric bypass, with unchanged secretin: a randomized controlled trial.
Heinonen S, Karppinen JE, Saarinen T … +4 more , Groop PH, Juuti A, Holst JJ, Pietiläinen KH
Int J Obes (Lond) · 2026 May · PMID 41495448 · Full text
BACKGROUND: Few studies have compared gut hormone responses between bariatric procedures. This study compared Roux-en-Y and one-anastomosis gastric bypass (RYGB and OAGB) regarding glucagon-like peptide-1 (GLP-1), secret...
BACKGROUND: Few studies have compared gut hormone responses between bariatric procedures. This study compared Roux-en-Y and one-anastomosis gastric bypass (RYGB and OAGB) regarding glucagon-like peptide-1 (GLP-1), secretin, and glucose-insulin dynamics. METHODS: This study included 41 participants (RYGB: n = 21, OAGB: n = 20) from the randomized RYSA trial with similar amounts of bypassed intestine between the procedures. Plasma GLP-1, secretin, glucose, insulin, and C-peptide were measured during a 360-min mixed-meal test before, and at 6- and 12-months after surgery. Outcomes included total and early-phase (0-60 min) areas under the curve (AUCs) and peak concentrations. Visual analogue scales were used to measure hunger and satiety. RESULTS: Both procedures resulted in ~25% weight loss and marked metabolic improvements over 12 months. While fasting GLP-1 remained largely unchanged, postprandial concentrations rose markedly at 6 months (total AUC increase in RYGB: ~330%, OAGB: ~259%; p < 0.001) and remained elevated at 12 months. The increases in early-phase GLP-1 AUC were 31% higher in RYGB than OAGB at 6 months (95% CI: 3 to 68; p = 0.030) and 25% higher at 12 months (95% CI: -2 to 59; p = 0.072). Peak GLP-1 increases were significantly higher ( ~ 32%) after RYGB at both follow-ups (p < 0.05). Postprandial reduction in hunger was greater after RYGB than OAGB from baseline to 12 months. Fasting or postprandial secretin concentrations showed no significant changes. Both operations were associated with decreased fasting glucose, insulin, and C-peptide; increased early glucose but decreased glucose total AUCs; and increased insulin early AUC and C-peptide total and early AUCs. Glucose early-phase AUC and peak concentration increases were greater after RYGB than OAGB. CONCLUSIONS: Both RYGB and OAGB lead to markedly enhanced postprandial GLP-1 responses, with no corresponding change in secretin levels. RYGB produces higher early postprandial increases in GLP-1 and glucose than OAGB, demonstrating that procedural differences can influence gut hormone and glucose responses.
Intersectional inequality in general and central obesity: cross-sectional UK Biobank study.
Hutchinson J, Darko N, Hardy R … +3 more , Webb D, Zaccardi F, Johnson W
Int J Obes (Lond) · 2026 Apr · PMID 41491274 · Full text
BACKGROUND: People exist at a combination of different individual and neighbourhood deprivations. Each of these combinations may have a unique impact on health. However, little is known about the intersectional inequalit...
BACKGROUND: People exist at a combination of different individual and neighbourhood deprivations. Each of these combinations may have a unique impact on health. However, little is known about the intersectional inequality of these combinations on general and central obesity, including when considering their demographics. This study aims to answer these questions. METHODS: The sample comprised 452,339 participants from the UK Biobank study. Individuals were grouped into 320 intersectional strata according to their household income, neighbourhood deprivation, sex, ethnicity and age. Linear and logistic multilevel analysis of individual heterogeneity and discriminatory accuracy was used to establish the total, additive and interactive inequality of body mass index (BMI), fat mass index (FMI), and waist to height ratio (WHtR), as well as the associated obesity classifications. RESULTS: 6.5%, 25.2% and 9.1% of the total variation in BMI, FMI and WHtR, respectively, was due to inequality between the strata. Of this, 26.5%, 3.5% and 22.0% is interactive. 79, 58 and 93 strata for BMI, FMI and WHtR demonstrate a significant interactive effect. We found some patterns; for example, affluent white women have an advantaged interactive effect, whilst deprived black women have a disadvantaged effect. Meanwhile men experience the inverse relationship. The relationship between individual and neighbourhood deprivation is not universally experienced by all strata. For example, black men living in areas of high deprivation have higher BMIs as their household income increases. CONCLUSIONS: A large proportion of variation in general and central obesity is due to intersectional inequality, with up to 26.5% being interactive. It is important that these intersectional effects are considered when designing policy interventions to avoid policy failure, such as by focussing on groups with high total and interactive risk.
Mental health outcomes in obesity interventions with GLP-1 receptor agonists: is it similar to other obesity interventions? A narrative review with systematic evidence synthesis.
Osborne D, Abdelgadir E
Int J Obes (Lond) · 2026 May · PMID 41491273 · Publisher ↗
Obesity is a chronic, debilitating condition with complex biological, psychosocial, and behavioral underpinnings. While the cardiometabolic consequences are reasonably well-established, the often-forgotten bidirectional...
Obesity is a chronic, debilitating condition with complex biological, psychosocial, and behavioral underpinnings. While the cardiometabolic consequences are reasonably well-established, the often-forgotten bidirectional association between obesity and mental health disorders, including anxiety, eating disorders, depression, and even suicidal ideations, is rarely assessed as a primary endpoint in obesity intervention studies. Similarly, documents summarizing and comparing various types of obesity interventions and their effects of mental health in this rapidly evolving field are scarce. This narrative review synthesizes the evidence on the psychological impact of lifestyle, pharmacological, and surgical interventions in the treatment of obesity. Special focus is placed on glucagon-like peptide-1 (GLP-1) receptor agonists, given their rising global use and emerging concerns regarding mental health safety. A thorough literature review was conducted across the MEDLINE, Embase, and Cochrane databases, focusing on meta-analyses, systematic reviews, and clinical trials published up to June 2025. Studies examining psychological outcomes in patients undergoing lifestyle modifications, pharmacotherapy, or bariatric surgery for weight loss were included. Mental health domains considered included quality of life, anxiety, depression, and suicidality. Due to the vast array of obesity interventions and the broad nature of mental health in the literature, this review was conducted to provide a narrative summary. Behavioral interventions consistently showed no harm to mental health and demonstrated modest improvements in depression and mental health-related quality of life. Bariatric surgery was associated with short-to-medium-term reductions in depressive and anxiety symptoms, though long-term benefits were attenuated, with some studies reporting increased suicidality after five years. Pharmacotherapies, including orlistat, bupropion/naltrexone, and phentermine/topiramate, showed mixed psychiatric impacts. The GLP-1 receptor agonists (Semaglutide, liraglutide, Tirzepatide) have shown an improvement in patient-reported mental wellbeing in several trials. Concerningly, pharmacovigilance data initially suggested a possible link with suicidality; however, subsequent robust cohort studies and meta-analyses have refuted this association. Mental health is a critical yet underprioritized element of obesity management. The current evidence suggests that most weight loss interventions are psychologically safe or beneficial, but long-term data remain limited, particularly for GLP-1 receptor agonists. Future randomized trials must incorporate mental health as a prespecified outcome, and individualized treatment approaches should integrate psychological support to optimize long-term outcomes. This review has summarized, side-by-side, the various outcomes of obesity interventions on mental health.
Sex-specific longitudinal associations between repeatedly measured movement behaviours and adiposity measures in school-aged children: a compositional data analysis approach.
Padmapriya N, Sadananthan SA, Michael N … +16 more , Tint MT, Tan SYX, Chia A, Kway YM, Cai S, Toh JY, Tan KH, Chong YS, Lee YS, Yap F, Chong MF, Godfrey KM, Eriksson JG, Bernard JY, Velan SS, Müller-Riemenschneider F
Int J Obes (Lond) · 2026 Mar · PMID 41491272 · Publisher ↗
BACKGROUND: Movement behaviours, including moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behaviour (SB), and sleep, influence childhood adiposity. However, th...
BACKGROUND: Movement behaviours, including moderate-to-vigorous-intensity physical activity (MVPA), light-intensity physical activity (LPA), sedentary behaviour (SB), and sleep, influence childhood adiposity. However, their collective impact on adiposity from a sex-specific perspective remains underexplored. Our research examined the sex-specific longitudinal associations of 24-h movement behaviours with body mass index (BMI) and abdominal adiposity among children. METHODS: In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort study, we repeatedly measured 24-h movement behaviours using wrist-worn accelerometers (ActiGraph GT3x) and assessed adiposity (BMI, abdominal circumference, and MRI-based abdominal fat volumes) at three time points (ages 5.5-6, 7.5-8, and 10-10.5 years) within the same children in a longitudinal design. Compositional multivariable linear mixed-effect modelling and isotemporal substitution were used to estimate the associations. RESULTS: 531 children (49.5% girls) were included in the analysis. Significant interactions between movement behaviours and sex were observed across all outcomes. In girls, higher MVPA relative to other behaviours was linked to lower BMI [-0.8 (-1.5, -0.1) kg/m²] and total abdominal adiposity [-225.5 (-451.6, -2.5) mL], while in boys, longer sleep duration was associated with lower BMI [-1.6 (-3.2, -0.1) kg/m²] and total abdominal adiposity [-624.2 (-1225.6, -31.3) mL]. The isotemporal substitution model showed that replacing 30 min of LPA/SB with MVPA reduced BMI and abdominal circumference by 1-2% and MRI-measured abdominal adiposity by 6-9% in both sexes. However, replacing LPA/SB with sleep reduced BMI and abdominal circumference by 1% and MRI-measured adiposity by 3-6% only in boys, with no changes in girls. These associations were pronounced on visceral adiposity. CONCLUSION: This study highlights sex-specific associations of movement behaviours with adiposity in school-aged children, with stronger associations observed in MRI-derived measures compared to conventional adiposity indices. Replacing LPA/SB with MVPA reduced BMI and abdominal adiposity in both sexes, with particularly pronounced effects on visceral adiposity. However, sleep replacement benefits were observed only in boys, suggesting the need for gender-sensitive approaches in lifestyle interventions.
The effect of obesity and aging on NAD/Sirtuin metabolism transcription and DNA methylation in subcutaneous adipose tissue of monozygotic twin pairs discordant for BMI.
Lapatto HAK, van der Kolk BW, Muniandy M … +15 more , Heinonen S, Heikkinen A, Alvarez M, Lee SHT, Jokinen R, Lundbom J, Kuula J, Hakkarainen A, Groop PH, Kaprio J, Tukiainen T, Ollikainen M, Pajukanta P, Pirinen E, Pietiläinen KH
Int J Obes (Lond) · 2026 Apr · PMID 41491271 · Full text
INTRODUCTION: The expression and/or activity of sirtuins (SIRTs), nicotinamide adenine dinucleotide (NAD)-dependent enzymes that regulate cellular energy metabolism, is decreased in obesity and in aging in animal models....
INTRODUCTION: The expression and/or activity of sirtuins (SIRTs), nicotinamide adenine dinucleotide (NAD)-dependent enzymes that regulate cellular energy metabolism, is decreased in obesity and in aging in animal models. However, the impact of obesity compared to aging on NAD/SIRT expression in human white adipose tissue (AT) remains unexplored. Here, we unravel the effects of obesity and aging on the expression of NAD/SIRT pathway and their associated genes in subcutaneous AT of identical twin pairs discordant for weight, in two age groups. METHODS: We examined 49 monozygotic twin pairs discordant for BMI (within-pair difference in BMI ≥ 2.5 kg/m, with mean BMIs 25.6 kg/m (leaner) and 30.8 kg/m (heavier), aged 22-38 and 56-69 years. Detailed phenotyping included body composition, insulin resistance (oral glucose tolerance test) and plasma lipids and inflammation markers. RNA sequencing and DNA methylation analyses in AT identified differentially expressed and methylated NAD/SIRT pathway genes in obesity and aging, with linear mixed models linking gene expression to metabolic features. RESULTS: SIRT5 and NAD biosynthetic genes were downregulated in AT in both obesity and aging. Obesity was characterized by downregulation of AT NAD/SIRT genes, and NAD/SIRT regulated mitochondrial oxidative metabolism genes, and upregulation of stress markers. Aging showed a downregulation of AT PARPs, except upregulation for PARP1, a main consumer of NAD. Mitochondrial metabolism and glycolysis genes were linked to corresponding DNA methylation. Downregulation of NAD/SIRT genes correlated with increased adiposity, insulin resistance, inflammation, and dyslipidemia. CONCLUSION: Impaired NAD/SIRT metabolism in AT may play a key role in obesity- and aging-related diseases. Both conditions are characterized by downregulation of NAD/SIRT pathway genes, correlating with increased adiposity, insulin resistance, inflammation, and dyslipidemia. Obesity uniquely disrupts expression of NAD/SIRT regulated mitochondrial genes, while aging is characterized by altered PARP expression, particularly increased PARP1, likely exacerbating metabolic dysfunction in AT.
Distinct fasting and postprandial bile acid responses following Roux-en-Y and one-anastomosis gastric bypass.
Jänis M, Saarinen T, Karppinen JE … +6 more , Groop PH, Neuvonen M, Niemi M, Juuti A, Pietiläinen KH, Heinonen S
Int J Obes (Lond) · 2026 May · PMID 41486179 · Full text
OBJECTIVE: Bariatric surgery is the most effective long-term treatment for obesity, but how different surgical techniques affect metabolic outcomes remains unclear. Bile acids (BAs), increasingly recognized as metabolic...
OBJECTIVE: Bariatric surgery is the most effective long-term treatment for obesity, but how different surgical techniques affect metabolic outcomes remains unclear. Bile acids (BAs), increasingly recognized as metabolic regulators, rise postprandially after surgery and may mediate some of these effects. This exploratory study investigates the differential impact of Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB) on BA profiles and associated metabolic outcomes over one year. METHODS: Forty-five patients with obesity (15 men, 30 women; mean (SD) age 46.6 (7.1) years) were randomized to receive either RYGB (n = 24) or OAGB (n = 20). Clinical assessments, body composition measurements (Dual energy X-ray absorptiometer), fasting blood tests including lipids and inflammation markers, 360-minute mixed meal test, and oral glucose tolerance test were conducted 4-6 weeks before and at 6 and 12 months after operation. Plasma total and 15 individual BAs (LC-MS) were measured at eight time points during the mixed meal test. RESULTS: RYGB led to an increase in postprandial secondary BAs from baseline to 12 months (p = 0.004), particularly deoxycholic acid (DCA; p < 0.001) and glycodeoxycholic acid (GDCA; p = 0.006) compared with OAGB. In contrast, OAGB led to an increase in postprandial primary taurine-conjugated BAs (p = 0.039), especially taurochenodeoxycholic acid (TCDCA; p = 0.036) compared with RYGB. Similarly, RYGB increased unconjugated secondary BAs, especially DCA, whereas OAGB increased conjugated primary BAs, like TCA and GCA during fasting. Metabolic improvements were similar in both groups. Post-RYGB increases in secondary BAs correlated with improved insulin sensitivity and post-OAGB increases in primary taurine-conjugated BAs correlated with higher fat mass preservation during weight loss. CONCLUSIONS: RYGB and OAGB differentially modulate BA profiles over one year, with RYGB increasing secondary BAs and OAGB increasing taurine-conjugated primary BAs. These findings suggest distinct mechanisms contributing to their metabolic benefits.
Is lower extremity joint replacement surgery associated with weight loss? An institutional retrospective study of 36,993 cases.
Ren R, Giannakis P, Zhong H … +6 more , Poeran J, Illescas A, Cozowicz C, Reisinger L, Memtsoudis SG, Liu J
Int J Obes (Lond) · 2026 May · PMID 41484351 · Publisher ↗
Total joint arthroplasty (TJA), including total hip (THA) and knee arthroplasty (TKA), improves mobility and quality of life. While often assumed to promote weight loss, evidence on long-term weight change remains mixed....
Total joint arthroplasty (TJA), including total hip (THA) and knee arthroplasty (TKA), improves mobility and quality of life. While often assumed to promote weight loss, evidence on long-term weight change remains mixed. In this large retrospective cohort study of 36,993 adults undergoing primary TJA at a tertiary academic center (2016-2021), we characterize weight and BMI changes following TJA, and identify postoperative weight patterns across preoperative BMI subgroups. BMI and weight were recorded at surgery and at routine 3-month postoperative intervals. Patients were stratified by baseline BMI to assess weight trajectories across subgroups (<25, 25 to <30, 30 to <35, 35 to <40, ≥40 kg/m²). Both THA and TKA patients demonstrated modest short-term BMI reductions within 1-3 months (-0.55% and -1.15%, respectively). However, by 13-15 months, net BMI change approached baseline for THA (-0.09%) and TKA (-0.65%). Patients with BMI ≥ 40 kg/m² exhibited the greatest initial loss (-1.30%) but later rebounded above baseline (+0.21%). Across all BMI groups, absolute changes in BMI and body weight were minimal, with an inflection toward weight regain at 7-9 months. Thus, TJA does not necessarily drive clinically meaningful or lasting weight loss, underscoring the importance of integrated perioperative weight-management strategies, particularly for patients with obesity.
Capturing metabolic syndrome: new thresholds for insulin resistance and novel body composition indices.
Frigerio F, Vitozzi A, Piciocchi C … +16 more , Ricci F, De Marinis M, Galfano V, Lubrano C, Mariani S, Gangitano E, Minnetti M, Muzzioli L, Lenzi A, Caprio M, Isidori AM, Gnessi L, Migliaccio S, Siervo M, Donini LM, Poggiogalle E
Int J Obes (Lond) · 2026 Mar · PMID 41484350 · Publisher ↗
BACKGROUND: Despite being a defining feature of metabolic syndrome (MetS), clinical assessment of IR remains challenging, due to the costs of reference methods and the numerosity of IR indices. Furthermore, to which exte...
BACKGROUND: Despite being a defining feature of metabolic syndrome (MetS), clinical assessment of IR remains challenging, due to the costs of reference methods and the numerosity of IR indices. Furthermore, to which extent IR contributes to MetS, while controlling for altered body composition, is still largely unexplored. OBJECTIVES: The present work aims at proposing new cut points for IR among people with overweight and obesity, assessing the concordance of different IR definitions and investigating how IR interacts with body composition in predicting MetS status. SUBJECTS: 665 patients were assessed for potential enrolment, using a cross-sectional design. The following inclusion criteria were applied: age ≥18 years, body mass index ≥25 kg/m, White European, no fulfilled criterion for diabetes mellitus, no current pregnancy. METHODS: Concordance of previously validated IR definitions was assessed by Cohen's κ. ROC curve analysis with 5-fold cross-validation was used to determine novel cut points for IR indices based on MetS presence. Finally, mediation analysis was employed to test whether IR mediates the relationship between body composition indices (i.e., fat mass-to-fat-free mass ratio, FM:FFM and appendicular lean soft tissue-to-visceral fat area ratio, ALST:VFA) and MetS. RESULTS: A total of 515 patients were included in the final analysis (females: 80.9%; MetS prevalence: 40%). Overall, IR definitions which previously validated against the hyperinsulinemic-euglycemic clamp displayed the highest level of agreement. The following cut-points were identified from ROC curve analysis: ISI-Matsuda<3.33 (AUROC = 0.675, p < 0.001), HOMA-IR > 2.93 (AUROC = 0.663 p < 0.001), HOMA2-IR > 1.67 (AUROC = 0.651 p < 0.001). Finally, ALST:VFA but not FM:FFM significantly predicted MetS status independent of age, with the mediating role of ISI-Matsuda, HOMA-IR and HOMA2-IR. CONCLUSIONS: IR indices mediated the effect of altered body composition (i.e., reduced appendicular muscularity and increased visceral adiposity) on MetS. Newly proposed diagnostic thresholds can aid in the identification of IR among patients at increased cardio-metabolic risk.
The effect of resveratrol supplementation on anthropometric indices, adiponectin and leptin levels in individuals with overweight and obesity: a graded, systematic review and meta-analysis of randomized controlled trials.
Setayesh A, Arzhang P, Baniasadi MM … +2 more , Lahouti M, Azadbakht L
Int J Obes (Lond) · 2026 Mar · PMID 41455817 · Publisher ↗
BACKGROUND: The effects of resveratrol supplementation on anthropometric indices, adiponectin, and leptin levels remain inconclusive in individuals with overweight and obesity. METHOD: This systematic review and meta-ana...
BACKGROUND: The effects of resveratrol supplementation on anthropometric indices, adiponectin, and leptin levels remain inconclusive in individuals with overweight and obesity. METHOD: This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effects of resveratrol supplementation on anthropometric indices, adiponectin, and leptin levels. We searched electronic databases, including Scopus, Web of Science, and PubMed, up to September 2025, to identify eligible RCTs. RESULTS: A total of 23 RCTs, involving 1005 participants, met the inclusion criteria for the meta-analysis. Resveratrol supplementation did not significantly affect body weight (WMD: -1.42 kg; 95% CI: -3.19, 0.35; P = 0.117), body mass index (BMI) (WMD: -0.47 kg/m²; 95% CI: -0.96, 0.01; P = 0.055), fat mass (FM) (WMD: 0.47 kg; 95% CI: -1.75, 2.69; P = 0.679), body fat percentage (BFP) (WMD: -0.88%; 95% CI: -1.91, 0.15; P = 0.094), fat-free mass (FFM) (WMD: 1.42 kg; 95% CI: -1.04, 3.89; P = 0.257), waist-hip ratio (WHR) (WMD: -0.00; 95% CI: -0.01, 0.00; P = 0.436), adiponectin (WMD: 1.84 µg/mL; 95% CI: -2.25, 5.95; P = 0.378), or leptin (WMD: 1.87 ng/mL; 95% CI: -3.84, 7.60; P = 0.521). However, resveratrol supplementation significantly reduced waist circumference (WC) (WMD: -1.93 cm; 95% CI: -3.10, -0.76; P = 0.001). Subgroup analyses revealed significant reductions in body weight and BMI with doses <1000 mg/day, longer interventions (≥12 weeks), and in females. Additionally, FFM increased significantly among participants aged <50 years, and leptin levels were significantly elevated in both sexes. CONCLUSION: This meta-analysis showed that resveratrol supplementation did not significantly impact most anthropometric measures and serum leptin and adiponectin in individuals with overweight and obesity. However, it led to a significant reduction in waist circumference. The PROSPERO registration number: is CRD42024497932.
A prediction model for childhood obesity risk based on maternal thyroid status and related parameters using machine learning: a mother-newborn-offspring study in a mild-to-moderate iodine deficiency area.
Ovadia YS, Bilenko N, Mazza O … +10 more , Fisch-Shvalb N, Paradise Vit A, Rosen SR, Avrahami-Benyounes Y, Groisman L, Rorman E, Ketslakh T, Anteby EY, Gefel D, Shenhav S
Int J Obes (Lond) · 2026 Apr · PMID 41454183 · Publisher ↗
BACKGROUND: Childhood obesity and iodine deficiency are prevalent in developed countries and are linked to adverse health outcomes in adulthood. Mild-to-moderate iodine deficiency and insufficient maternal iodine intake...
BACKGROUND: Childhood obesity and iodine deficiency are prevalent in developed countries and are linked to adverse health outcomes in adulthood. Mild-to-moderate iodine deficiency and insufficient maternal iodine intake during pregnancy may increase the risk of large-for-gestational-age newborns, which are associated with childhood obesity. Despite this, predicting childhood obesity during pregnancy remains a challenge. We assessed and evaluated machine learning algorithms predicting childhood obesity risk using maternal anthropometrics, thyroid function and iodine intake; and identified key prenatal factors contributing to childhood obesity. METHODS: A diagnostic accuracy study was conducted based on 87 parameters collected from a mother-newborn-offspring prospective cohort (N = 191) in a mild-to-moderate iodine deficiency region. Maternal iodine status and thyroid function, including serum free tri-iodo-thyronine (FT3) concentrations, were assessed during the second half of pregnancy. Iodine intake was evaluated using a semi-quantitative food frequency questionnaire. Anthropometric measurements were obtained from mothers during pregnancy, from newborns at birth, and from children at 2 years of age. An outcome of overweight at 2 years was defined as a gender-adjusted weight percentile >85%. The dataset was split into training (80%) and test (20%) sets. Synthetic datasets were created to evaluate the performance of six machine learning models, including artificial neural networks (Nnet) that trained and evaluated the model using 5-fold cross-validation. RESULTS: The best-performing model was Nnet, which achieved the highest accuracy (1500 instances with a balanced predicted outcome). On the unseen test data, accuracy, Kappa, outcome F1-score and weighted F1 were 0.743, 0.347, 0.500 and 0.769 (respectively). Significant predictors included gravidity, maternal-newborn anthropometrics (height and head circumference, respectively), maternal consumption and dietary intake of iodine-rich foods (popsicle, selected fish, and yogurt) and FT3. CONCLUSIONS: Machine learning approaches show promise in predicting childhood obesity risk using maternal and dietary factors during pregnancy. If validated, these findings could support interventions to reduce childhood obesity rates.
Genetic and environmental effects on weight gain from young adulthood to old age and its association with body mass index in early young adulthood: an individual-based pooled analysis of 16 twin cohorts.
Obeso A, Drouard G, Jelenkovic A … +44 more , Ordoñana JR, Sánchez-Romera JF, Colodro-Conde L, Ollikainen M, Aaltonen S, Corley RP, Huibregtse BM, Medda E, Fagnani C, Toccaceli V, Gatz M, Butler DA, Bartels M, Ligthart L, de Geus EJ, Christensen K, Skytthe A, Kyvik KO, Medland SE, Gordon SD, Rasmussen FE, Tynelius P, Franz CE, Kremen WS, Lyons MJ, Spector T, Mangino M, Lachance G, Magnusson PK, Pedersen NL, Dahl Aslan AK, Duncan GE, Buchwald D, Pyun H, Lee J, Lee SJ, Sung J, Bruins S, Pool R, Eriksson A, Martin NG, Boomsma DI, Kaprio J, Silventoinen K
Int J Obes (Lond) · 2026 Apr · PMID 41444398 · Publisher ↗
INTRODUCTION: Genetic and environmental factors contribute to weight gain, but how these effects change over adulthood is largely unknown. We examined how genetic factors influence BMI changes from young adulthood to old...
INTRODUCTION: Genetic and environmental factors contribute to weight gain, but how these effects change over adulthood is largely unknown. We examined how genetic factors influence BMI changes from young adulthood to old age and how this change relates to BMI in early adulthood. DATA AND METHODS: Data from 16 longitudinal twin cohorts, including 111,370 adults (56% women) and 55,657 complete twin pairs (42% monozygotic), were pooled. The data were divided into three stages (young adulthood-early middle age, late middle age, and old age). BMI changes were calculated via linear mixed effects and delta slope methods. Genetic and environmental contributions to these changes and their correlations with BMI in early young adulthood were estimated through structural equation modeling. RESULTS: The average BMI increase per year was 0.18 kg/m² in men and 0.15 kg/m² in women during young adulthood-early middle age (18-50 years), decreasing to ≤0.07 kg/m² at older ages. Genetic effects contributed to variance of BMI changes during young adulthood-early middle age (men a² = 0.29; women a² = 0.26) and less so in late middle age (51-64 years) (men a² = 0.05; women a² = 0.16) and old age ( > 65 years) (men a² = 0.13; women a² = 0.18). Most variation was explained by non-shared environmental effects (e² = 0.71-0.95 in men and e²= 0.74-0.84 in women). In men, greater BMI during early young adulthood (18-30 years) was associated with lower BMI changes later in life (r = -0.22 to -0.13), and the association was driven by genetic (r = -0.27) and non-shared environmental (r = -0.22 to -0.14) factors. In contrast, the association was positive in women (r = 0.05-0.28) and was explained by genetic factors (r=0.27-0.51). CONCLUSION: Genotype influences BMI changes across adulthood, with its effect varying by age and sex. Environmental effects are the main drivers of adult BMI changes, highlighting the role of modifiable factors in long-term weight regulation.
Postbiotics: emerging regulatory mechanisms and therapeutic applications in obesity and its complications.
Zhou G, Wang R, Fu C … +9 more , Du Y, Li X, Xia Q, Zhou J, Li Z, Li X, Gong C, Sun Y, Xu H
Int J Obes (Lond) · 2026 May · PMID 41444397 · Publisher ↗
Obesity is a growing global health issue, leading to complications such as cardiovascular diseases, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and chronic inflammation. Existing treatments for people wit...
Obesity is a growing global health issue, leading to complications such as cardiovascular diseases, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), and chronic inflammation. Existing treatments for people with obesity, including lifestyle changes, pharmaceutical interventions, and surgical procedures, have certain limitations, highlighting the need for alternative therapies. Postbiotics, as inanimate microbial metabolites, offer a novel therapeutic approach. This review discusses how postbiotics exert anti-obesity effects through various mechanisms, including regulation of lipid metabolism and energy homeostasis, gut microbiota modulation, endogenous systemic regulation, inflammatory immunomodulation and intestinal barrier function enhancement, along with other synergistic effects. Our work also evaluates their clinical application potential, emphasizing the safety, efficacy, and advantages over traditional treatments like pharmaceuticals and surgery. Despite promising early clinical trial results, challenges remain in translating postbiotics into clinical practice, including the need for long-term studies to assess their sustained efficacy and safety, standardized production processes, scalability, and addressing individual variability in treatment responses. Overall, postbiotics represent a sustainable and personalized therapeutic strategy for managing obesity and its complications.
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