Obesity Pillars最新文献

{"title":"Vicarious efficacy of tirzepatide in a cohabiting couple: An observational case report","authors":"Kieran Eason ,&nbsp;Claire Feeney ,&nbsp;Tim Killeen","doi":"10.1016/j.obpill.2025.100219","DOIUrl":"10.1016/j.obpill.2025.100219","url":null,"abstract":"<div><h3>Introduction</h3><div>Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, produces substantial weight loss and glycaemic improvement in people with and without type 2 diabetes mellitus (T2DM). Obesity pharmacotherapy may influence household behaviours and indirectly affect untreated cohabitants, but no prior report has described such an effect.</div></div><div><h3>Patient main concerns and findings</h3><div>A cohabiting couple presented with obesity. The female partner (Patient A; no diabetes) sought weight loss therapy; the male partner (Patient B) had long-standing T2DM managed with insulin. Both partners were motivated to lose weight but had previously been unsuccessful through diet alone.</div></div><div><h3>Primary diagnoses interventions and outcomes</h3><div>Patient A began tirzepatide through a pharmacy-supervised weight management programme (escalated to 5 mg weekly). Patient B did not receive any pharmacotherapy but lived in the same household. Over 32 weeks, Patient A lost &gt;30 % of baseline weight. Patient B lost 13 % of baseline weight, HbA1c fell from 9.5 % to 6.1 %, and insulin requirements declined by approximately 70 %. These outcomes paralleled those reported in tirzepatide clinical trials despite absence of medication in Patient B.</div></div><div><h3>Conclusion</h3><div>This case illustrates potential household-level or “vicarious” efficacy of anti-obesity pharmacotherapy. Environmental and behavioural changes in one partner may yield indirect metabolic benefits for untreated cohabitants. Recognition of such effects could inform patient counselling, cost-effectiveness assessments, and future research into family-based obesity care.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100219"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361964","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":"Systematic review of parental influence on pediatric obesity: Exploring dietary habits, physical activity, and intervention strategies","authors":"Surendra Gupta ,&nbsp;Purushottam Lal ,&nbsp;Rakesh Sharma ,&nbsp;Abhishek Gupta ,&nbsp;Brajesh Raj Chaudhary","doi":"10.1016/j.obpill.2025.100218","DOIUrl":"10.1016/j.obpill.2025.100218","url":null,"abstract":"<div><h3>Objectives</h3><div>The purpose of this systematic review was to synthesize current evidence on the effectiveness of family-centered interventions that target parental behaviors such as dietary habits, physical activity, and sedentary patterns, in reducing childhood obesity risk. Rather than examining parental behaviors as independent predictors, this review focuses on interventions designed to modify them.</div></div><div><h3>Material and methods</h3><div>A comprehensive literature search was conducted using electronic databases including Medline/PubMed and EMBASE, supplemented by hand searching. Eligible studies included randomized controlled trials, quasi-experimental, observational, qualitative, and mixed-methods designs involving children aged 0–18 years. Interventions focused on parental behaviors related to diet, physical activity, and sedentary habits. Data extraction was performed independently by two reviewers, with risk of bias assessed using standard tools appropriate to study design. Narrative synthesis and meta-analyses, where appropriate, were conducted using random-effects models to account for study heterogeneity.</div></div><div><h3>Results</h3><div>Five randomized controlled trials met inclusion criteria, encompassing parent-only and family-based behavioral interventions across diverse populations. Parent-focused interventions with booster sessions consistently demonstrated significant reductions in children's body mass index z-scores compared to standard or no intervention. Secondary outcomes, including improvements in dietary habits and psychosocial factors, were reported but with less consistency. Risk of bias was low to moderate overall, though limitations included small sample sizes and variable follow-up durations.</div></div><div><h3>Conclusions</h3><div>Parental involvement is pivotal in pediatric obesity management. Family-centered behavioral interventions, particularly those incorporating booster supports, effectively reduce childhood obesity risk. Limitations of current evidence include methodological heterogeneity and limited long-term data. Future research should focus on paternal roles, diverse populations, and standardized outcome reporting. Systematic review registration: PROSPERO [CRD42025640314].</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100218"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473672","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":"Improving screening for disordered eating behaviors in pediatric weight management using quality improvement methodology","authors":"Roohi Y. Kharofa ,&nbsp;Sanita L. Ley ,&nbsp;Kristin M. Stackpole ,&nbsp;Jessica A. Lin ,&nbsp;Carolina M. Bejarano ,&nbsp;Katelyn Gordon ,&nbsp;Shelley Kirk ,&nbsp;Melissa Burbrink ,&nbsp;Robert M. Siegel","doi":"10.1016/j.obpill.2025.100198","DOIUrl":"10.1016/j.obpill.2025.100198","url":null,"abstract":"<div><h3>Background</h3><div>Adolescents with obesity are at increased risk for disordered eating behaviors (DEBs). Despite screening being recommended, identification of DEBs in pediatric weight management (PWM) remains inadequate.</div></div><div><h3>Methods</h3><div>The aim of this quality improvement project was to increase provider documentation of screening for DEBs from 44 % to 80 % for new patients, age ≥12, seen at a PWM program over a 10-month period. Interventions were grouped into four PDSA cycles: 1. Provider education, 2. Screening tool implementation, 3. Systematic use of screening tool, and 4. Implementation of an electronic screener. The primary outcome was the percent of patients with documentation of DEB screening. Data was plotted on a p-chart. Standard statistical process control methods were used.</div></div><div><h3>Results</h3><div>Mean documentation rates for DEBs increased from a baseline of 44 %–85 %, with special cause analysis demonstrating improvement. Referrals for DEBs increased from 13 % at baseline to 19 %.</div></div><div><h3>Conclusion</h3><div>Consistently screening for disordered eating behaviors in pediatric weight management is feasible. Quality improvement methodology can be utilized to help identify and act on facilitators and barriers to screening. Improved screening may lead to earlier identification of high-risk patients and prompt referral to mental health practitioners.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703519","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":"The impact of ultra-processed foods on pediatric health","authors":"Venkata Sushma Chamarthi ,&nbsp;Pallavi Shirsat ,&nbsp;Kunal Sonavane ,&nbsp;Saketh Parsi ,&nbsp;Usha Ravi ,&nbsp;Harikrishna Choudary Ponnam ,&nbsp;Shagun Bindlish ,&nbsp;Evan P. Nadler ,&nbsp;Rahul Kashyap ,&nbsp;Sarah Ro","doi":"10.1016/j.obpill.2025.100203","DOIUrl":"10.1016/j.obpill.2025.100203","url":null,"abstract":"<div><h3>Introduction</h3><div>Ultra-processed foods (UPFs) have become increasingly incorporated into pediatric diets, accounting for approximately 67 % of the total energy consumption in United States (US) children. Manufactured through industrial processing and enriched with excess sugars, unhealthy fats, and sodium, while lacking essential nutrients, UPFs present a substantial public health concern. We aimed to conduct a comprehensive review of the impact of UPFs on pediatric health.</div></div><div><h3>Methods</h3><div>We reviewed the effects of UPF on pediatric health using data from observational studies, systematic reviews, and policy reports. Our review explored the social, environmental, and economic drivers of UPF consumption, associated health consequences, and proposed mitigation strategies. We also examined National Health and Nutrition Examination Survey (NHANES) data, the 2025 US Dietary Guidelines Advisory Committee’s (USDA) report, and the Make America Healthy Again (MAHA) commission findings.</div></div><div><h3>Results</h3><div>UPF intake has dramatically increased during early childhood, with toddlers and school-aged children obtaining 47 % and 59.4 % of their daily calories, respectively, from UPFs. Higher consumption is linked to pediatric obesity, cardiometabolic risks such as insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), mental health concerns, and gut microbiome disruption. Early-life exposure to UPFs can establish unhealthy dietary patterns that persist into adulthood, raising the risk of chronic disease. Greater UPF consumption is often observed among lower-income families, highlighting a key health disparity.</div></div><div><h3>Conclusion</h3><div>UPF consumption is a modifiable risk factor for non-communicable diseases in children. Addressing it requires urgent, coordinated action at multiple levels. Strategies include UPF and sugar-sweetened beverage screening during well-child visits, policy restrictions on food marketing, clearer nutrition labeling, healthier school meals, and personalized family-centered dietary counseling. Clinicians need standardized tools and training to counsel families effectively. Policy initiatives should prioritize prevention-focused measures to protect children's health.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048595","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":"Childhood obesity management in primary care: Bridging guidelines and practice","authors":"Venkata Sushma Chamarthi ,&nbsp;Jennifer Lynn McCauley ,&nbsp;Evan P. Nadler ,&nbsp;Sarah Ro","doi":"10.1016/j.obpill.2025.100225","DOIUrl":"10.1016/j.obpill.2025.100225","url":null,"abstract":"<div><h3>Introduction</h3><div>Childhood obesity continues to escalate in prevalence and severity, affecting nearly one in five U.S. children. Severe obesity is the fastest-growing subcategory, with disproportionately high rates among adolescents, non-Hispanic Black and Hispanic youth, and those from lower socioeconomic backgrounds. The resulting burden spans the life course, increasing risks for metabolic, cardiovascular, and psychosocial complications.</div></div><div><h3>Methods</h3><div>This is a narrative commentary based on a synthesis of current literature, clinical guidelines, and expert consensus regarding the integration of obesity management into pediatric primary care. The manuscript draws upon recent epidemiologic data, educational frameworks, and policy recommendations to highlight opportunities for workforce development and training reform.</div></div><div><h3>Results</h3><div>Key findings emphasize significant gaps between guideline recommendations and real-world practice. Despite strong evidence for early intervention, most pediatricians receive limited formal training in obesity medicine, leaving them unprepared to deliver pharmacotherapy, coordinate bariatric referrals, or manage comorbidities. The commentary identifies actionable strategies to address these deficits, including integration of obesity medicine into undergraduate and graduate medical education, expansion of continuing medical education and mentorship pathways, and the role of certification programs such as the American Board of Obesity Medicine (ABOM) in advancing competency across the pediatric workforce.</div></div><div><h3>Conclusion</h3><div>Bridging the gap between guidelines and practice requires a national commitment to equip primary care providers with the skills and confidence to treat obesity as a chronic disease. Embedding obesity medicine training into medical curricula, supporting practicing clinicians through structured continuing education, and advocating for system-level changes such as reimbursement reform and telehealth expansion are critical to reversing the pediatric obesity epidemic.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100225"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473666","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":"An obesity care curriculum improves residents’ self-efficacy and clinical practice habits","authors":"Marci Laudenslager ,&nbsp;Kacey Chae ,&nbsp;Sean Tackett ,&nbsp;Amanda Bertram ,&nbsp;Kimberly A. Gudzune","doi":"10.1016/j.obpill.2025.100223","DOIUrl":"10.1016/j.obpill.2025.100223","url":null,"abstract":"<div><h3>Background</h3><div>Most residency programs lack formal curricula on obesity care leaving physicians unprepared to treat obesity. After conducting a targeted needs assessment, we refined a previously developed online obesity care curriculum and determined its effect on resident physicians’ outcomes.</div></div><div><h3>Methods</h3><div>This study employed a prospective, non-randomized, pre-post design to evaluate the impact of an online obesity care curriculum on resident physicians' obesity care self-efficacy and frequency of self-reported clinical practice habits. Participants included internal medicine, family medicine, preventive medicine, and internal medicine-pediatrics residents. The curriculum was offered as a standalone experience (‘curriculum only’) or part of a 10-day obesity medicine elective (‘curriculum + elective’). We recruited 45 residents – 33 selected the ‘curriculum only’ and 12 selected the ‘curriculum + elective’ option. We evaluated changes pre/post across 10 obesity care self-efficacy domains (1-not at all confident; 4-very confident) and self-reported frequency of 10 clinical practice habits (1-never; 5-always) among all residents. We used paired t-tests to calculate mean pre/post changes and compared outcomes between the ‘curriculum only’ and ‘curriculum + elective’ groups using unpaired t-tests. Given the multiple comparisons, we considered a statistically significant result if p-value &lt;0.005 (Bonferroni correction).</div></div><div><h3>Results</h3><div>Overall, residents completed a mean of 9.5 (SD 2.7) of 11 core e-modules. Residents significantly increased self-efficacy and frequency across obesity care domains (p &lt; 0.005); largest increases in frequency were in discussing metabolic-bariatric surgery (mean change 0.8, SD 1.0), behavioral counseling (0.8, SD 1.2), referring to weight management programs (0.7, SD 0.7), and discussing obesity medications (0.6, SD 0.9). No significant differences in pre/post changes were found comparing ‘curriculum only’ to ‘curriculum + elective.’</div></div><div><h3>Conclusion</h3><div>This curriculum's positive impact on clinical practice habits is an important precursor that may lead to changes in treatment outcomes for patients with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100223"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473667","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":"Integrating digital health into pediatric obesity management: Current practices and future perspectives","authors":"Vittoria Frattolillo,&nbsp;Alessia Massa ,&nbsp;Dalila Capone ,&nbsp;Noemi Monaco,&nbsp;Gianmario Forcina,&nbsp;Pierluigi Di Filippo,&nbsp;Pierluigi Marzuillo,&nbsp;Emanuele Miraglia del Giudice,&nbsp;Anna Di Sessa","doi":"10.1016/j.obpill.2025.100189","DOIUrl":"10.1016/j.obpill.2025.100189","url":null,"abstract":"<div><h3>Background</h3><div>Childhood obesity is a growing global health concern with significant cardiometabolic consequences. While conventional treatment approaches often fail to achieve sustained outcomes, emerging digital health interventions (DHIs)—including mobile applications, educational video games, wearable devices, telemedicine, and social media—offer innovative tools to support lifestyle modifications and enhance therapeutic adherence.</div></div><div><h3>Methods</h3><div>In this narrative review, we focus on the main evidence regarding the effectiveness of DHIs for pediatric obesity treatment according to target (children vs. children with families) and duration (short- and long-term interventions). We also review their impact on clinical (e.g. body mass index, body composition, etc.), behavioral (physical activity, nutrition, adherence) and psychosocial (motivation, engagement) outcomes. In addition, future trends in the field are also discussed.</div></div><div><h3>Results</h3><div>DHIs demonstrate short-term effectiveness, especially when they incorporate personalization, interactivity, and family involvement. Mobile applications and educational video games boost nutritional literacy and promote healthy behaviours. Wearable devices encourage physical activity awareness, though adherence often varies. Long-term, family-based interventions help reduce dropout rates and reinforce lasting healthy habits. Guided use of social media can facilitate health education but also exposes users to risks such as misinformation and unhealthy food marketing. Despite these advancements, DHIs still face major challenges, including unequal access, data privacy concerns, and a lack of long-term outcome evaluations.</div></div><div><h3>Conclusion</h3><div>The increasing prevalence of pediatric obesity underscores the urgent need for effective and sustainable treatment strategies. DHIs represent a promising, scalable approach for managing childhood obesity, but their long-term sustainability and effectiveness remain to be fully established. Ongoing technological advancements—and their thoughtful integration into existing healthcare frameworks—present significant opportunities to develop innovative, patient-centered therapeutic solutions that can improve engagement, adherence, and long-term health outcomes in children and adolescents with obesity.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580402","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":"Developing and implementing an obesity medicine fellowship program: Experience at a U.S. academic medical center","authors":"Zoobia W. Chaudhry ,&nbsp;Marci Laudenslager ,&nbsp;Kimberly A. Gudzune ,&nbsp;Selvi Rajagopal","doi":"10.1016/j.obpill.2025.100204","DOIUrl":"10.1016/j.obpill.2025.100204","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a prevalent and complex chronic disease yet physicians’ training in obesity care is often inadequate. Fellowship training in obesity medicine is now available at multiple academic medical centers; however, there has been limited description and evaluation of these programs to date. Therefore, this article describes our curriculum development process and fellowship program implementation experience at a U.S. academic medical center.</div></div><div><h3>Methods</h3><div>This was a structured, multi-phase curriculum development study guided by established obesity medicine competencies and certification standards. We used a six-step approach to curriculum development to guide our design with content informed by the Obesity Medicine Education Collaborative competencies, American Board of Obesity Medicine (ABOM) content outline, and Accreditation Council for Graduate Medical Education - International Obesity Medicine Fellowship program requirements. We utilized several tools of instruction as well as modes of assessing learners. Feedback from fellows and faculty was used to iteratively refine the program over the initial 3 years.</div></div><div><h3>Results</h3><div>We identified 19 content domains key for obesity medicine. Within each domain, we created instructional components including didactic e-lectures, directed readings, reflective assignments, role play activities, and clinical experiences. We developed evaluation tools to determine trainee progress including knowledge check assessments, mini-clinical evaluation exercises (mini-CEXs), and structured feedback. Early outcomes indicate that trainees achieve competence in obesity care, engage in meaningful scholarly activity, and benefit from professional development opportunities. All graduating fellows have successfully achieved ABOM certification. Feedback has informed fellowship refinements, particularly improvements in rotation timing and duration as well as additional subspecialty elective options.</div></div><div><h3>Conclusion</h3><div>This obesity medicine fellowship curriculum provides a structured, multidisciplinary program and graduates have achieved competency in obesity care. Obesity medicine fellowship training holds promise in advancing the field through innovative education and leadership development.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925170","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":"Impact of physical activity and BMI on health-related quality of life in overweight Indian adolescents: A randomized controlled study","authors":"Prateek Srivastav ,&nbsp;K. Vaishali ,&nbsp;H. Vinod Bhat ,&nbsp;Suzanne Broadbent","doi":"10.1016/j.obpill.2025.100201","DOIUrl":"10.1016/j.obpill.2025.100201","url":null,"abstract":"<div><h3>Background</h3><div>Health-related quality of life (HRQOL) is a critical yet often overlooked component of adolescent obesity management. While physical activity (PA) and body mass index (BMI) are established markers of health, their combined influence on HRQOL in Indian adolescents remains underexplored.</div></div><div><h3>Objective</h3><div>To examine how PA and BMI influence overall and domain-specific HRQOL in overweight and adolescents with obesity following a structured lifestyle program.</div></div><div><h3>Methods</h3><div>In this randomized controlled study, 604 adolescents (aged 11–16 years) with BMI above the 85th percentile were recruited from schools in Udupi, India. Individuals were randomized into three groups: multifactorial strategy (MFI: exercise, lifestyle education, behavioral counseling), exercise-only (EX), and Control group (CON). PA was measured using the Physical Activity Questionnaire for Adolescents (PAQ-A), and HRQOL was measured via the Pediatric Quality of Life Inventory (PedsQL 4.0). Linear mixed-effects models evaluated associations between PA, BMI, and HRQOL over a 12-month period, which included a 12-week intervention followed by 9 months of follow-up.</div></div><div><h3>Results</h3><div>PA was linked with better HRQOL in the MFI (β = 9.30, p &lt; 0.001) and EX (β = 4.47, p &lt; 0.001) groups. Interestingly, higher BMI correlated with better HRQOL scores in both program arms. The CON group showed no meaningful association between PA and HRQOL. The domain-level analysis found that PA and BMI were positively linked to physical, emotional, social, and school functioning in both program groups, with more pronounced effects in the MFI group. The CON group showed improvement only in emotional functioning related to BMI.</div></div><div><h3>Conclusion</h3><div>Structured PA programs, especially those combining education and behavioral support, notably enhance the quality of life among overweight Indian adolescents. These findings reinforce the importance of focusing not solely on weight loss, but on holistic, behavior-driven health outcomes in adolescent obesity care.</div></div><div><h3>Clinical trial registration</h3><div>CTRI/2019/04/018,834.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100201"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889615","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":"Cross-sectional associations between intrinsic and extrinsic motivation for physical activity and body composition in adolescents with obesity","authors":"Fábio de Freitas ,&nbsp;Mariana R. Zago ,&nbsp;Maria Ângela Antônio ,&nbsp;António Videira-Silva ,&nbsp;Maria Ângela Bellomo Brandão","doi":"10.1016/j.obpill.2025.100197","DOIUrl":"10.1016/j.obpill.2025.100197","url":null,"abstract":"<div><h3>Background</h3><div>Motivation is essential in turning the intention to engage in physical activity (PA) into consistent action, promoting healthier and more sustainable habits. This study aimed to identify the motivational factors associated with engagement in a PA program and examine the relationship between motivation and body composition in adolescents with obesity.</div></div><div><h3>Methods</h3><div>Fifty adolescents (60.0 % boys); Median age of 13.6 years (IQR: 2.4); Median BMI z-score of 3.42 (IQR: 1.55) recruited for a PA program were included in this cross-sectional study. All participants completed standardized body composition assessments and an online questionnaire assessing five motivational domains: enjoyment and competence (intrinsic), and appearance, fitness, and social (extrinsic domains).</div></div><div><h3>Results</h3><div>Fitness emerged as the main reason for engaging in the PA program (6.41 ± 0.81), followed by appearance (5.64 ± 1.43), enjoyment (4.98 ± 1.47), competence (4.55 ± 1.99), and social (3.79 ± 1.85). Enjoyment and competence showed significant negative associations with body weight. (<em>r</em>_<em>p</em> = −0.29, p = 0.045; <em>r</em>_<em>p</em> = −0.32, p = 0.027). Regression analysis identified fitness as a significant predictor for BMI z-score (β = 0.4, p = 0.027).</div></div><div><h3>Conclusion</h3><div>Extrinsic motives, such as fitness and appearance may drive PA engagement in treatment-seeking adolescents with obesity. However, intrinsic motives, such as enjoyment and competence, may be inversely associated with BMI z-score. Thus, targeting both extrinsic and intrinsic motivation may help to improve adherence and weight outcomes in obesity care. More studies with larger samples are needed to confirm these findings.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100197"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686543","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}