Obesity Pillars最新文献

{"title":"Erratum to “Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society” [Obesity Pillars 15C (2025) 100181]","authors":"Dariush Mozaffarian , Monica Agarwal , Monica Aggarwal , Lydia Alexander , Caroline M. Apovian , Shagun Bindlish , Jonathan Bonnet , W. Scott Butsch , Sandra Christensen , Eugenia Gianos , Mahima Gulati , Alka Gupta , Debbie Horn , Ryan M. Kane , Jasdeep Saluja , Deepa Sannidhi , Fatima Cody Stanford , Emily A. Callahan","doi":"10.1016/j.obpill.2026.100268","DOIUrl":"10.1016/j.obpill.2026.100268","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"18 ","pages":"Article 100268"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society [Obesity Pillars 15 (2025) 100181]","authors":"Dariush Mozaffarian , Monica Agarwal , Monica Aggarwal , Lydia Alexander , Caroline M. Apovian , Shagun Bindlish , Jonathan Bonnet , W Scott Butsch , Sandra Christensen , Eugenia Gianos , Mahima Gulati , Alka Gupta , Debbie Horn , Ryan M. Kane , Jasdeep Saluja , Deepa Sanndhi , Fatima Cody Stanford , Emily A. Callahan","doi":"10.1016/j.obpill.2026.100263","DOIUrl":"10.1016/j.obpill.2026.100263","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"18 ","pages":"Article 100263"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Sarcopenic obesity in type 2 diabetes: An underrecognized clinical challenge” [Obesity Pillars 18 (2026) 100270]","authors":"Amit Jaiswal, Manish Arya, Dharmendra B. Sharma","doi":"10.1016/j.obpill.2026.100271","DOIUrl":"10.1016/j.obpill.2026.100271","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"18 ","pages":"Article 100271"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional priorities to support GLP-1 therapy for obesity: a joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society","authors":"Dariush Mozaffarian , Monica Agarwal , Monica Aggarwal , Lydia Alexander , Caroline M Apovian , Shagun Bindlish , Jonathan Bonnet , W Scott Butsch , Sandra Christensen , Eugenia Gianos , Mahima Gulati , Alka Gupta , Debbie Horn , Ryan M Kane , Jasdeep Saluja , Deepa Sanndhi , Fatima Cody Stanford , Emily A Callahan","doi":"10.1016/j.obpill.2026.100269","DOIUrl":"10.1016/j.obpill.2026.100269","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide 1 receptor agonists and combination medications (hereafter collectively referred to as GLP-1s) are shifting the treatment landscape for obesity. However, real-world challenges and limited clinician and public knowledge on nutritional and lifestyle interventions can limit GLP-1 efficacy, equitable results, and cost-effectiveness.</div></div><div><h3>Objectives</h3><div>We aimed to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment of obesity for the practicing clinician.</div></div><div><h3>Methods</h3><div>An expert group comprising multiple clinical and research disciplines appraised the scientific literature, informed by expert knowledge and clinical experience, to identify and summarize relevant topics, priorities, and emerging directions.</div></div><div><h3>Results</h3><div>GLP-1s reduce body weight by 5% to 18% in trials, with modestly lower effects in real-world analyses, and multiple demonstrated clinical benefits. Challenges include side effects, especially gastrointestinal; nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence with subsequent weight regain; and high costs with resulting low cost-effectiveness. Numerous practice guidelines recommend multicomponent, evidence-based nutritional and behavioral therapy for adults with obesity, but use of such therapies with GLP-1s is not widespread. Priorities to address this include: (a) patient-centered initiation of GLP-1s, including goals for weight reduction and health; (b) baseline screening, including usual dietary habits, emotional triggers, disordered eating, and relevant medical conditions; (c) comprehensive exam including muscle strength, function, and body composition assessment; (d) social determinants of health screening; (e) and lifestyle assessment including aerobic activity, strength training, sleep, mental stress, substance use, and social connections. During GLP-1 use, nutritional and medical management of gastrointestinal side effects is critical, as is navigating altered dietary preferences and intakes, preventing nutrient deficiencies, preserving muscle and bone mass through resistance training and appropriate diet, and complementary lifestyle interventions. Supportive strategies include group-based visits, registered dietitian nutritionist counseling, telehealth and digital platforms, and Food is Medicine interventions. Drug access, food and nutrition insecurity, and nutrition and culinary knowledge influence equitable obesity management with GLP-1s. Emerging areas for more study include dietary modulation of endogenous GLP-1, strategies to improve compliance, nutritional priorities for weight maintenance post-cessation, combination or staged intensive lifestyle management, and diagnostic criteria for clinical obesity.</div></div><div><h3>Conclusions</h3><div>Evidence-based nutritional and lifestyle strategies play a pivota","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"18 ","pages":"Article 100269"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking back control: The experience of adults using semaglutide and tirzepatide for obesity treatment - A qualitative study","authors":"Lauren Lynn Trocchio ,&nbsp;Fredrick Peters","doi":"10.1016/j.obpill.2025.100237","DOIUrl":"10.1016/j.obpill.2025.100237","url":null,"abstract":"<div><h3>Background</h3><div>Adequately treating obesity remains a fundamental goal for improving quality of life and long-term health outcomes. Semaglutide and tirzepatide have shown clinically meaningful weight loss in clinical trials, yet despite this weight loss efficacy, little is understood about how patients with obesity using semaglutide or tirzepatide experience making dietary behavior change. Furthermore, little is known about their perceptions of obesity treatment and healthcare provider interactions since taking the medications.</div></div><div><h3>Methods</h3><div>This was a basic qualitative study wherein adults with obesity taking semaglutide or tirzepatide participated in in-depth interviews and open-ended questionnaires. Participation criteria included a Body Mass Index (BMI) ≥ 30.0 kg/m², taking semaglutide (between 1.0 and 2.4 mg) or tirzepatide (between 5.0 and 15.0 mg) for 6–18 months, and a weight loss of 7 %–20 %. Individual demographic data were reported, and interview transcripts and questionnaires were thematically analyzed.</div></div><div><h3>Results</h3><div>The final sample included 8 participants (100 % female, mean age 42). Three themes addressed the experience of dietary behavior change: (a) feeling more capable, (b) more measured and deliberate with dietary choices, and (c) experiencing a reduced mental burden. Four themes addressed the experience of obesity treatment: (a) frustration with historical guidance and treatment, (b) hopeful about treatment for the first time, (c) compassion for self and others, and (d) unanticipated outcomes. Finally, two themes addressed the experience of healthcare provider interactions: (a) physicians as gatekeepers to the medications, and (b) physicians were not the initial introduction to the medications.</div></div><div><h3>Conclusion</h3><div>The findings suggest the medications provide a sense of hope for effective treatment, facilitate dietary behavior change, and evoke quality of life benefits beyond weight loss. The patient-provider relationship and obesity knowledge of the physician are integral in discussing and acquiring the medications, yet patients initially learn about the medications outside the healthcare system.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicability of the New Zealand-eating behavior questionnaire to predict weight loss responses to naltrexone/bupropion: a proof-of-concept trial","authors":"Ole Schmiedel ,&nbsp;Melissa Ivey ,&nbsp;Nishi Karunasinghe ,&nbsp;Rinki Murphy","doi":"10.1016/j.obpill.2025.100240","DOIUrl":"10.1016/j.obpill.2025.100240","url":null,"abstract":"<div><h3>Background</h3><div>Despite the availability of different obesity medications, individual responses vary widely. This pilot study evaluated whether the New Zealand Eating Behavior Questionnaire (NZ-EBQ) could predict weight loss response to naltrexone/bupropion in adults with clinical obesity.</div></div><div><h3>Methods</h3><div>We conducted a 24-week prospective, single-site, pilot, exploratory, phenotype-stratified trial evaluating utility of the NZ-EBQ for predicting weight reduction response to naltrexone/bupropion. Prior to enrolment, participants completed the NZ-EBQ, which classified their eating behavior phenotype and hypothesized congruence or incongruence with treatment allocation. The primary outcomes were changes in body weight and body mass index (BMI) at 12 and 24 weeks between emotional eaters and other phenotypes (reduced satiety or satiation) tested using independent t-tests and linear regression (significance threshold p &lt; 0.10).</div></div><div><h3>Results</h3><div>Of 67 participants enrolled, 44 (65.7 %) completed 12 weeks and 37 (55.2 %) completed 24 weeks. Median baseline weight was 133.1 kg (IQR: 111.6–151.7). At 24 weeks, mean weight loss was 4.54 % (95 % CI: 2.83–6.25 %). Participants with emotional eating lost significantly more weight (6.44 %, 95 % CI: 3.64–9.24) than those with reduced satiation (4.69 %, 95 % CI: 0.23–9.15) or reduced satiety (2.82 %, 95 % CI: 0.33–5.30). In multiple linear regression analysis, primary eating behavior trait score and family history of obesity were significant predictors of weight loss (B = 16.8, SE = 10.9, p = .13, 95 % CI: 5.59 – 39.15). The safety profile, including rate of withdrawal and treatment-related adverse events, was consistent with results reported in pivotal studies with naltrexone/bupropion.</div></div><div><h3>Conclusion</h3><div>These findings suggest that participants with emotional eating lost more weight after naltrexone/bupropion than those with other eating behavior phenotypes identified using the NZ-EBQ. Further trials are warranted to validate these preliminary results.</div><div>Australia and New Zealand Clinical Trials Registry (ACTRN12622000703707).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100240"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145749891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of obesity medications in those with low response to a low-energy diet meal replacement programme: An observational study","authors":"James Shand ,&nbsp;Yannan Jiang ,&nbsp;Rinki Murphy","doi":"10.1016/j.obpill.2026.100245","DOIUrl":"10.1016/j.obpill.2026.100245","url":null,"abstract":"<div><h3>Background</h3><div>It is not known how individuals respond to liraglutide or naltrexone/bupropion following low-response to a structured meal replacement low energy diet (MR-LED) programme.</div></div><div><h3>Methods</h3><div>This was a retrospective observational study conducted at a specialist weight management service using MR-LED with intensive behavioural therapy (IBT). Adults were considered for obesity medication if they did not lose at least 5 % body weight in the first 4 weeks of the intensive MR phase, 10 % after the total 12 week MR phase or regained &gt;4 kg either during the stepped food reintroduction or weight maintenance phases. Eligible individuals were offered liraglutide 3.0 mg (LIRA) or naltrexone/bupropion (NB32) for 13 weeks (including dose titration). The primary outcome was the proportion of individuals achieving ≥5 % weight reduction after 13 weeks of treatment. Completers were defined as those who had a body weight measured between 10 and 16 weeks and did not discontinue the medication before this period.</div></div><div><h3>Results</h3><div>Of 114 people offered obesity medications, 85 accepted (67 LIRA, 18 NB32). 46 individuals completed 13 weeks’ treatment and 11 (24 %) achieved ≥5 % weight reduction. Among completers (54 %), the mean weight change was −4.4 kg (−2.4 %), and was −2.7 kg (−1.5 %) for the total treated cohort using last weight carried forward on missing data. Those achieving ≥5 % weight reduction were more likely to be male and had lower prevalence of diabetes, binge eating, anxiety or depressive symptoms at baseline.</div></div><div><h3>Conclusion</h3><div>People who do not respond to a MR-LED with IBT have lower than anticipated weight reduction on subsequent treatment with first-generation obesity medications.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testosterone therapy effects adipose distribution in older females post hip-fracture: The STEP-HI study","authors":"Jacob E. Earp ,&nbsp;Shangshu Zhao ,&nbsp;Furong Xu ,&nbsp;Chia-Ling Kuo ,&nbsp;Jenna M. Bartley ,&nbsp;Richard H. Fortinsky ,&nbsp;Jatupol Kositsawat ,&nbsp;Carlos O. Rehbein ,&nbsp;Ellen F. Binder ,&nbsp;Jennifer Stevens-Lapsley ,&nbsp;George A. Kuchel","doi":"10.1016/j.obpill.2026.100247","DOIUrl":"10.1016/j.obpill.2026.100247","url":null,"abstract":"<div><h3>Background</h3><div>With aging and injury, females experience ectopic redistribution of appendicular adipose tissue (AAT) into the visceral compartment, where adipose tissue (VAT) becomes highly inflammatory and increases risk of reinjury and chronic illness. Therefore, strategies that can disrupt this unhealthy adipose redistribution after hip fracture injury are of great interest. We examined the effects of testosterone therapy on total adipose tissue (TAT) and adipose distribution in older females recovering from hip fracture.</div></div><div><h3>Methods</h3><div>This was a sub-analysis of the STEP-HI study, a multi-site randomized clinical trial in which older females recovering from hip fracture were assigned to a 6-month exercise intervention combined with either topical testosterone gel (EX + T, n = 35, age = 79 ± 9 years) or placebo gel (EX + P, n = 31, age = 76 ± 7 years). Changes in TAT, AAT, and VAT mass and percentage of TAT in each region (%AAT and %VAT) were measured using dual x-ray absorptiometry, and changes over the 6-month intervention were compared between groups.</div></div><div><h3>Results</h3><div>Over the intervention, changes were similar in TAT (EX + P: 298 ± 2002 g, EX + T: 419 ± 2086 g, p = 0.810), AAT (EX + P: 52 ± 1007 g, EX + T: 39 ± 1078 g, p = 0.810), %AAT (EX + P: 0.42 ± 1.40% of TAT, EX + T: 0.52 ± 1.67% of TAT, p = 0.792) and VAT (EX + P: 45 ± 232 g; EX + T: −44 ± 151 g; p = 0.073). However, relative changes in %VAT from pre-intervention (EX + P: Δ3.51 ± 18.42%; EX + T: −Δ10.57 ± 17.13%; p = 0.004) marked favorable effects of testosterone on relative visceral adiposity.</div></div><div><h3>Conclusion</h3><div>While testosterone did not decrease overall adipose stores compared to exercise alone in older females recovering from hip fracture, it did promote a healthy pattern of adipose distribution away from the viscera.</div></div><div><h3>Clinical trial #</h3><div>NCT02938923.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145976500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic sleeve gastrectomy in a patient with type 1 diabetes and kidney transplant: A case report","authors":"María José Ayora- Pérez ,&nbsp;Eduardo Andrés Román Cataña ,&nbsp;Bernarda Patiño-Araujo ,&nbsp;María Emilia Salgado-Báez ,&nbsp;Gabriel Patricio Villavicencio-Logroño ,&nbsp;Gabriela Zapata-Jaramillo ,&nbsp;Napoleón Salgado-Macías","doi":"10.1016/j.obpill.2025.100243","DOIUrl":"10.1016/j.obpill.2025.100243","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity in patients with type 1 diabetes mellitus (T1DM) and kidney disease presents unique challenges, particularly after transplantation, where weight gain can compromise graft function and metabolic control. Bariatric surgery has emerged as a therapeutic option in transplant recipients with obesity, though its role in T1DM remains less explored.</div></div><div><h3>Main concerns and clinical finings</h3><div>We report the case of a 45-year-old man with longstanding T1DM complicated by hypertension, diabetic retinopathy, and end-stage renal disease, who underwent a deceased-donor kidney transplant at age 40. Post-transplant, he developed type III obesity (BMI 44.5 kg/m²), poor glycemic control (HbA1c 9.8 %), and severe hepatic steatosis despite intensive medical therapy.</div></div><div><h3>Intervention</h3><div>Laparoscopic sleeve gastrectomy was performed without intraoperative complications (operative time 70 minutes, specimen weight 100 g, minimal blood loss). The postoperative course was notable only for a transient ileus requiring two days of hospitalization. At follow-up, the patient demonstrated significant weight loss, resolution of albuminuria, improved glycemic stability with marked reduction in insulin requirements, and improvement of hepatic steatosis. Importantly, immunosuppressant drug levels consistently remained within therapeutic range throughout follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlights the safety and efficacy of sleeve gastrectomy in a kidney transplant recipient with longstanding T1DM, resulting in significant metabolic, renal, and hepatic improvements without compromising graft function or immunosuppressive therapy. To our knowledge, this is the first reported case of sleeve gastrectomy in a patient with T1DM following kidney transplantation, underscoring its feasibility and the need for further research in this complex population.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100243"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Medicine Association (OMA) Position Statement on Medicare and Medicaid coverage and expanded access to obesity medications: Preliminary perspective 2025","authors":"Marisa Censani ,&nbsp;Angela Fitch ,&nbsp;Carolynn Starr Francavilla Brown ,&nbsp;Harold Edward Bays","doi":"10.1016/j.obpill.2025.100242","DOIUrl":"10.1016/j.obpill.2025.100242","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"17 ","pages":"Article 100242"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}