Clinical Obesity最新文献

{"title":"GLP-1 Receptor Agonists Versus Bariatric Surgery: Effects of Weight Loss and BMI on Subsequent General Surgical Procedures","authors":"Shahzaib Zindani,&nbsp;Selamawit Woldesenbet,&nbsp;Abdullah Altaf,&nbsp;Mujtaba Khalil,&nbsp;Zayed Rashid,&nbsp;Jun Kawashima,&nbsp;Areesh Mevawalla,&nbsp;Azza Sarfraz,&nbsp;Sabrena Noria,&nbsp;Bradley Needleman,&nbsp;Timothy M. Pawlik","doi":"10.1111/cob.70075","DOIUrl":"10.1111/cob.70075","url":null,"abstract":"<p>Obesity and T2DM substantially increase postoperative risk, with higher surgical site infections in obesity and up to a 65% increase in overall complications in T2DM. This study assesses the impact of weight loss interventions—metabolic bariatric surgery (MBS) and glucagon-like peptide-1 receptor agonists (GLP-1RA)—on BMI reduction and how that translates to postoperative outcomes in general surgery patients. Patients undergoing general surgery (2016–2024) were identified in the Epic Cosmos database. GLP-1RA or MBS exposure occurred 1–3 years preoperatively (GLP-1RA coverage ≥ 80%). Entropy balancing produced weighted cohorts with similar baseline profiles, followed by multivariable regression models assessing the association between weight loss intervention and BMI change, and the impact of BMI on postoperative outcomes. Overall 9470 individuals underwent a general surgery procedure. Median patient age was 64, with mostly females (60.6%). More patients received GLP-1RA (<i>n</i> = 7823, 82.3%) than MBS (<i>n</i> = 1647, 17.4%). MBS patients had higher initial BMIs (≥ 40: 60.8% vs. 24.5%, <i>p</i> &lt; 0.001). MBS led to greater BMI reduction than GLP-1RA (Mean difference: −9.89, 95% CI: −9.64, −10.34). Higher BMI at time of a general surgical procedure correlated with increased postoperative complications (OR: 1.01, 95% CI: 1.00–1.01) and extended LOS (OR: 1.01, 95% CI: 1.00–1.01). MBS was associated with lower complication odds (OR: 0.87, 95% CI: 0.78–0.98). MBS improved surgical outcomes in patients with obesity and T2DM through greater BMI reduction compared with GLP-1RAs. These findings support the role of preoperative weight loss to mitigate surgical risk; however, evaluating outcomes relative to no intervention remains an important future direction.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12972600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomised Feasibility Study Assessing Acute Physiological Responses to Weight Stigma in Women Living With Obesity","authors":"Adrian Brown,&nbsp;Jed Wingrove,&nbsp;Stuart W. Flint","doi":"10.1111/cob.70073","DOIUrl":"10.1111/cob.70073","url":null,"abstract":"<p>Experimental evidence indicates that exposure to weight stigma can lead to sustained elevations in cortisol and ambulatory blood pressure. However, little is known about its acute effects on other physiological markers. This study aimed to explore the feasibility of measuring the physiological response of weight stigma, a novel weight stigmatising paradigm and preliminary efficacy signals. In a prospective randomised feasibility study, women living with obesity were assigned to either a weight stigmatising or non-weight stigmatising paradigm (15 min) and physiological response measured from baseline to 120 min. Eighteen women living with obesity were recruited (nine participants in each group; mean age 43.2 years (SD 10.3); body mass index of 45.8 kg/m² (SD 5.9); 72.2% White ethnicity). Preliminary efficacy showed an observed acute increase in plasma cortisol (26.7 pg/mL, 95% CI −5.5 to 58.9), alongside increased systolic blood pressure (12.7 mmHg, 95% CI 0.6–24.8), self-reported stress (17.4 mm 95% CI 1.6–33.3), appetite (hunger/desire to eat; 16.8 mm, 95% CI 2.0–31.7; 20.9 mm 95% CI 5.1–36.7, respectively), reduction in peptide YY (−11.8 pg/mL 95% CI −21.6 to −2.01) and fullness (−13.9 95% CI −27.6 to −0.3). No differences were found between the intervention and control group in all measured parameters. Furthermore, this study showed that recruitment, randomisation and measuring real-time physiological response was feasible. This is the first feasibility study attempting to comprehensively characterise the acute physiological impact of experiencing weight stigma in people living with obesity in an experimental setting. Future appropriately powered studies are needed to confirm the preliminary efficacy findings.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of Obesity in India: Need for Policy Changes to Attain Highest Possible Level of Health and Well-Being","authors":"Sanjay Kalra,&nbsp;Jothydev Kesavadev,&nbsp;Ramen Goel,&nbsp;Muffazal Lakdawala,&nbsp;Vinayak Agrawal,&nbsp;Neena Malhotra,&nbsp;Nitin Kapoor,&nbsp;Neeta Deshpande,&nbsp;Ankush Desai,&nbsp;Viswanathan Mohan,&nbsp;Rajesh Khadgawat,&nbsp;Balram Sharma","doi":"10.1111/cob.70072","DOIUrl":"10.1111/cob.70072","url":null,"abstract":"<p>The rise in obesity rates in India in the past 3–4 decades is alarming and obesity management needs transformation. A significant barrier is that obesity is often viewed in India as a lifestyle condition rather than a chronic disease, despite broad international recognition of this status.</p><p>We propose four overall recommendations to drive transformation of obesity management in India:\u0000\u0000 </p><p>Policy change is needed in India to ensure that obesity is adequately managed, to improve health of the overall population and reduce disease burden and healthcare costs. Standardised treatment guidelines and algorithms will ensure that individuals with obesity receive up-to-date and consistent support. The burden of obesity can only be addressed through acceptance of obesity as a disease and collaboration across healthcare and policy stakeholders, with significant resource commitments at every level.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Class III Obesity as a Presenting Syndrome in Prolactinoma Patients: Insights Into Obesity and Metabolic Dysfunction in This Unique Group","authors":"Lukas Andereggen,&nbsp;Christoph Schmid,&nbsp;Michael Brändle,&nbsp;Emanuel Christ","doi":"10.1111/cob.70067","DOIUrl":"10.1111/cob.70067","url":null,"abstract":"<div>\u0000 \u0000 <p>The occurrence of patients with lactotroph adenoma presenting with class III obesity is extremely rare. This study reports long-term outcomes of such patients treated with transsphenoidal surgery (TSS) or dopamine agonists (DAs) and integrates findings with existing literature to explore prolactin's (PRL) role in obesity pathophysiology. We analysed BMI and metabolic changes and compared findings with published case series. Four patients presented with class III obesity (BMI range, 40.0–43.1 kg/m²). The diagnostic work-up revealed hyperprolactinemia (PRL range, 56.1–4389 μg/L) and hypogonadism in all patients, with sellar MRI indicating a macroadenoma in all but one patient. Over a median follow-up of 31 months (range 24–144), both TSS (<i>n</i> = 2) and DAs (<i>n</i> = 2) effectively controlled hyperprolactinemia and hypogonadism. BMI changes (ΔBMI/year) were −1.4 ± 1.8 kg/m²/year (TSS) and −3.9 ± 3.4 kg/m²/year (DAs), with non-significant metabolic improvements. Analysis of 22 additional cases revealed similar trends. Higher baseline BMI and macroprolactinoma were risk factors for persistent obesity. Early PRL screening in patients with class III obesity, weight loss interventions and long-term hyperprolactinemia management are essential. Both TSS and DAs provide metabolic benefits, highlighting the need for a multidisciplinary approach in diagnosing and managing lactotroph adenomas with obesity.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017445","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":"Correction to ‘Changes in Eating Behaviour During Treatment With Obesity Medications’","authors":"","doi":"10.1111/cob.70071","DOIUrl":"10.1111/cob.70071","url":null,"abstract":"<p>M. C. Chong, T. Y. L. Ko, P. L. le Roux, and C. W. le Roux, “Changes in Eating Behaviour During Treatment With Obesity Medications,” <i>Clinical Obesity</i> 16, no. 1 (2026): e70065, https://doi.org/10.1111/cob.70065.</p><p>Carel W. le Roux has also been added as a corresponding author.</p><p>We apologize for these errors.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cob.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient and Nutritional Deficiencies Associated With GLP-1 Receptor Agonist Therapy: A Narrative Review","authors":"Jorge Urbina,&nbsp;Luis Eduardo Salinas-Ruiz,&nbsp;César Valenciano,&nbsp;Benjamin Clapp","doi":"10.1111/cob.70070","DOIUrl":"10.1111/cob.70070","url":null,"abstract":"<div>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists (GLP-1RA) such as semaglutide, liraglutide and tirzepatide are effective for obesity and type 2 diabetes mellitus (T2DM) but may predispose users to micronutrient deficiencies through appetite suppression, delayed gastric emptying and altered absorption. Given the rapid rise in GLP-1RA use, clarifying their nutritional impact is clinically important. We conducted a structured search of PubMed and the Cochrane Database (January 2019–May 2025) for adult studies evaluating nutritional or micronutrient outcomes during GLP-1RA therapy. Paediatric studies, those lacking nutrient endpoints, and review articles were excluded. Methods followed SANRA and PRISMA-ScR guidance, and data were synthesised descriptively. Six studies met the inclusion criteria, encompassing 480 825 adults. Vitamin D deficiency was the most common abnormality, occurring in 7.5% at 6 months and 13.6% at 12 months. Iron depletion was frequent, with GLP-1RA users demonstrating 26%–30% lower ferritin levels than SGLT2 inhibitor comparators. More than 60% of users consumed below estimated requirements for calcium and iron, and vitamin D intake averaged 20% of recommendations. Protein and calcium insufficiency contributed to lean mass loss, while thiamine and cobalamin deficits increased over time. GLP-1RA therapy is associated with meaningful nutritional deficiencies. Targeted nutritional assessment and individualised laboratory evaluation may be appropriate for patients at increased risk of malnutrition. Findings are mainly derived from observational datasets, and causality between GLP-1RA therapy and nutritional deficiencies cannot be definitively established.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997595","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":"Classification of Obesity Based on Weight History: Perceptions of People With Obesity","authors":"Bruno Halpern,&nbsp;Simone van de Sande-Lee,&nbsp;Maria Edna de Melo,&nbsp;Rodrigo N. Lamounier,&nbsp;Cintia Cercato,&nbsp;Paulo Augusto Carvalho Miranda,&nbsp;Rodrigo O. Moreira,&nbsp;Mario Kehdi Carra,&nbsp;Cesar Luiz Boguszewski,&nbsp;Marcio C. Mancini","doi":"10.1111/cob.70068","DOIUrl":"10.1111/cob.70068","url":null,"abstract":"<p>Two Brazilian medical societies have proposed a new classification of obesity based on the maximum weight attained in an individual's lifetime, to be used in the clinical evaluation of individuals undergoing obesity treatment. This classification, which applies to adults aged 18 to 65 years, categorises people with obesity (PwO) who lose a certain percentage of their weight as having either ‘reduced’ or ‘controlled’ obesity. While the classification aims to improve patient care, there is limited data on PwO perceptions. To explore this, a cross-sectional online survey was conducted with 500 PwO, including an explanation and clinical case of the new classification. The survey revealed that 64% of participants had never been asked by a healthcare professional (HCP) about their maximum weight. After knowing the new classification, 82% found it useful for changing perceptions about obesity treatment; 66% felt it would encourage them to seek treatment; 63% believed it would help with treatment maintenance; and 74% indicated they would feel better achieving ‘controlled obesity,’ even if the weight loss fell short of their goals. A majority agreed that the classification could help establish realistic goals (77%) and reduce biases from HCPs (69%). Overall, PwO perceived the classification as beneficial for encouraging treatment and reducing stigma.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Approaches for Obesity in Children With Heterozygous MC4R Variants","authors":"Mostafa Salama,&nbsp;Leslie Saba,&nbsp;Lourdes Valdez,&nbsp;Aida Lteif,&nbsp;Seema Kumar","doi":"10.1111/cob.70069","DOIUrl":"10.1111/cob.70069","url":null,"abstract":"<div>\u0000 \u0000 <p>Melanocortin-4 receptor (MC4R) deficiency is the most common cause of monogenic obesity; yet treatment options for children with MC4R mutations are limited. We describe significant improvement in weight in three patients with pathogenic or likely pathogenic MC4R mutations; two adolescents treated with semaglutide, and a younger child treated with metformin and topiramate. These findings indicate GLP-1 receptor agonists, topiramate and metformin can be helpful in managing obesity associated with MC4R deficiency.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899420","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":"Lipoedema and Bariatric and Metabolic Surgery: A Systematic Review","authors":"Qamil Pajaziti,&nbsp;Georgios Geropoulos,&nbsp;Emma MacVicar,&nbsp;Nicola Colucci,&nbsp;James Lucocq,&nbsp;Peter J. Lamb,&nbsp;Andrew G. Robertson","doi":"10.1111/cob.70062","DOIUrl":"10.1111/cob.70062","url":null,"abstract":"<div>\u0000 \u0000 <p>Lipoedema is a chronic, progressive condition characterised by disproportionate fat accumulation in the lower extremities, often misdiagnosed due to symptom overlap with obesity. Weight management is a key component of lipoedema treatment, yet the role of bariatric surgery remains unclear. This systematic review evaluates the impact of bariatric and metabolic surgery (BMS) on lipoedema symptoms, weight loss outcomes, and the need for further interventions. A systematic search of PubMed, Scopus and the Cochrane Library was conducted up to January 2025 following PRISMA guidelines. Studies reporting on patients with lipoedema (or equivalent diagnoses) who underwent BMS were included. Quality was assessed using the Joanna Briggs Institute (JBI) checklist for case reports and the National Heart, Lung and Blood Institute (NHLBI) tool for case series. Seven studies met the inclusion criteria (five case reports, two cohort studies), comprising 51 patients. All underwent BMS, primarily sleeve gastrectomy or Roux-en-Y gastric bypass. One study (<i>n</i> = 31) reported a significant reduction in thigh volume and weight loss comparable to controls. The remaining studies found persistent or worsened lower body disproportionality and no improvement in pain. Postoperative lipoedema diagnoses were common, raising concerns over diagnostic accuracy. Overall weight loss averaged 33.9% total weight loss. Bariatric and metabolic surgery achieves meaningful weight reduction in patients with lipoedema and obesity but does not consistently improve core lipoedema symptoms. Its role remains adjunctive rather than primary. Preoperative identification and documentation of lipoedema features are recommended, with a postoperative plan for adjunct conservative therapies and selective consideration of lymph-sparing liposuction where symptoms persist. Larger prospective studies using standardised definitions and outcome measures are needed to clarify its therapeutic value in this population.</p>\u0000 </div>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809758","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":"Understanding the Impact of Weight on Quality of Life and Willingness to Pay for Obesity Management in the APAC Region","authors":"Hae-Jin Ko,&nbsp;Nitin Kapoor,&nbsp;Mariana Mercado Garcia,&nbsp;Sungeun Grace Jung,&nbsp;Jack Garcia Uranga Romano,&nbsp;Samantha L. Hocking","doi":"10.1111/cob.70066","DOIUrl":"10.1111/cob.70066","url":null,"abstract":"<p>Overweight and obesity are estimated to affect more than 40% of adults in the Asia-Pacific (APAC) region. This study used a cross-sectional online survey to assess the impact of obesity on health-related quality of life (HRQOL) using the Impact of Weight on Quality of Life (IWQOL)-Lite instrument and willingness to pay for obesity management among adults with body mass index (BMI) ≥ 18 kg/m² in Australia, India and South Korea. A total of 2952 adults completed the survey. Most respondents (82%) were concerned with their weight, increasing with obesity class. Rated on a scale of 0–100 (worst to best quality of life), the mean (SD) overall IWQOL-Lite score was 61 (30) with no differences by gender. The mean lowest score was in the self-esteem domain, with female respondents reporting greater impairment than male respondents (47 vs. 53, <i>p</i> &lt; 0.05). Total IWQOL-Lite and domain scores declined with increasing weight class (mean of 81 for individuals with normal weight to 35 for those with Obesity Class III). Of the 1752 individuals living with obesity, 80% would be willing to pay USD $25 per month for a weight loss method requiring minimal/moderate changes to diet, exercise and lifestyle that would enable them to achieve weight loss in 1 year; nearly half were willing to pay USD $225 per month. Our study highlights the negative impact of weight on the HRQOL of individuals in three APAC countries and the willingness to pay to achieve weight loss.</p>","PeriodicalId":10399,"journal":{"name":"Clinical Obesity","volume":"16 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12717460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}