Current Obesity Reports最新文献

{"title":"Prevalence and Predictors of Guideline Concordant Pediatric Obesity Care: A Narrative Review.","authors":"Colin J Orr, Aspen E Streetman, Ivan A Carruyo, Amy L Beck, Katie Queen, Tierra Sanders, William J Heerman","doi":"10.1007/s13679-026-00712-9","DOIUrl":"10.1007/s13679-026-00712-9","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: To summarize the current state of adoption of the 2023 American Academy of Pediatrics (AAP) Clinical Practice Guideline (CPG) for the evaluation and treatment of childhood obesity, identify barriers and facilitators to guideline-concordant care, and highlight gaps in research and clinical practice. RECENT FINDINGS: The AAP CPG outlines 13 Key Action Statements (KASs) for the screening, diagnosis, and treatment of pediatric obesity. Evidence suggests variable uptake across KASs. For example, BMI measurement (KAS 1) is limited by missed well-child visits and insurance disparities, while comprehensive evaluation (KAS 2) faces challenges in mental health and social needs screening. Screening for comorbidities such as dyslipidemia, diabetes, and metabolic dysfunction-associated steatoic liver disease (MASLD) remains low despite longstanding recommendations. Treatment-related KASs (11–13) show significant gaps: referrals to intensive health behavior and lifestyle interventions are infrequent, pharmacotherapy use is < 2% among eligible adolescents, and bariatric surgery referrals remain rare. Barriers include provider hesitancy, resource limitations, and systemic inequities; facilitators include electronic health record integration, multidisciplinary teams, and expanded insurance coverage. Despite strong evidence supporting early and intensive treatment of pediatric obesity, guideline adoption remains inconsistent. Addressing structural barriers, improving provider education, and leveraging health system innovations are critical for implementation. Future research should evaluate effective implementation strategies, long-term outcomes of pharmacotherapy, and approaches to adapt guidelines to local contexts. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13079462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intelligence-driven Mechanomedicine for Weight Rebound in Obesity.","authors":"Shanshan Zhu, Bo Cheng, Bin Gao, Feng Xu","doi":"10.1007/s13679-026-00714-7","DOIUrl":"10.1007/s13679-026-00714-7","url":null,"abstract":"<p><p>PURPOSE OF PERSPECTIVE: This perspective aims to propose a mechanomedicine framework integrating the body’s intrinsic “mechanical intelligence” (MI) with artificial intelligence (AI), offering new potential approaches for diagnosis and treatment of weight rebound. RECENT FINDINGS: Weight rebound after weight loss remains a significant challenge in obesity management. Traditional explanations focus on hormonal and metabolic adaptations, but emerging evidence underscores the importance of mechanical cues in adipose tissue. Persistent fibrosis and extracellular matrix (ECM) stiffness after weight loss may create a mechanical memory that favors weight rebound. We explore the biomechanics of adipose tissue during weight fluctuations, highlight the potential role of mechanobiology, and examine how AI help enhance mechanodiagnostics and mechanotherapy. Both physiological and mechanical factors contribute to weight rebound after initial loss. The integration of MI (biomechanics and mechanobiology) in adipose tissue with AI-driven mechanodiagnostics and mechanotherapy may offer a novel perspective and promising future solutions to prevent weight rebound and transform obesity treatment. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Obesity Prevention: A Call for Strategic and Operational Clarity.","authors":"Ximena Ramos Salas, Brad Hussey, Angela S Alberga, Ted Kyle, Francine Small","doi":"10.1007/s13679-026-00708-5","DOIUrl":"10.1007/s13679-026-00708-5","url":null,"abstract":"<p><p>BACKGROUND: Despite decades of initiatives promoting individual behavior change, obesity rates remain high and continue to rise globally, indicating that what is commonly labelled as “obesity prevention” is not, in practice, preventing obesity. While health promotion strategies and policy interventions have demonstrated improvements in environments, health behaviors, and industry practices, their effects on obesity incidence and prevalence remain modest. OBJECTIVE: To examine the mismatch between current obesity prevention practices and contemporary scientific understanding of obesity as a chronic disease, and to propose a reframed approach to prevention. METHODS: Conceptual analysis informed by empirical evidence and field insights. The authors conceptualize a broad misalignment between scientific understanding of obesity and prevention practice. RESULTS: Current prevention efforts primarily target individual health behaviors and environmental factors related to food and physical activity, rather than addressing the complex causes of obesity. Contemporary clinical guidance defines obesity as a chronic, complex, and relapsing disease characterised by excess or dysfunctional adiposity that impairs health, shaped by biological, genetic, behavioral, and environmental factors. Behavioral interventions produce small changes in BMI and do not reliably prevent the onset or progression of obesity. Evidence demonstrates that behaviors are partly driven by underlying biological and brain-based mechanisms, and that physiological systems resist sustained weight change. As a result, interventions focused primarily on individual behavior are insufficient to prevent a disease governed by interacting biological and systemic processes. Drawing on empirical evidence and field insights, the authors show that prevention efforts are further limited by narrow outcome measures, short-term policy cycles, fragmented accountability, and inconsistent disease classification. Obesity prevention efforts do not align with current scientific understanding of obesity as a chronic, complex, and relapsing disease. Obesity prevention should be redefined to explicitly target disease onset and progression. An integrated, multi-level framework is needed to align health promotion, prevention, and clinical care, addressing biological, behavioral, and system (social, physical, commercial) drivers simultaneously. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of GLP1 Receptor Agonists and Multi-agonist Incretin Therapies for Specific Obesity-related Health Conditions: Evidence and Rationale for Prioritisation.","authors":"Christo Albor, Oluwaseun Anyiam, Luke D Boyle, Janine Makaronidis, Rachael Tan, Sahar Iftikhar, Amna Burzic, Fannie Lajeunesse Trempe, Moira Stanley, Aniqah Bhatti, Jadine Scragg, Layla Badawy, Komal Moqeem, Iskandar Idris, Rob C Andrews, Piya Sen Gupta, David Hughes, Katherine McCullough, Tricia Tan, Barbara McGowan","doi":"10.1007/s13679-026-00707-6","DOIUrl":"10.1007/s13679-026-00707-6","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This review evaluates the strength and scope of clinical evidence for GLP-1RAs—liraglutide, semaglutide, and tirzepatide—across obesity and associated complications, providing a structured rationale for prioritisation in clinical practice and policy. RECENT FINDINGS: GLP-1RAs demonstrate significant and reproducible weight loss—approximately 15% with semaglutide and 20% with tirzepatide at one year. Their efficacy in obesity-related health conditions has been best demonstrated through large clinical trials in cardiovascular disease, type 2 diabetes, obstructive sleep apnoea and metabolic dysfunction-associated steatotic liver disease. There is emerging evidence in the form of clinical trials and large retrospective studies for a number of other health conditions including chronic kidney disease, polycystic ovary syndrome, osteoarthritis, and other inflammatory conditions. Finally, GLP-1RAs may be a safe and effective treatment in time-critical contexts requiring rapid weight reduction for access to interventions such as organ transplantation, oncology surgery, sight-threatening idiopathic intracranial hypertension, and assisted conception. While all individuals meeting NICE eligibility criteria should ultimately access GLP-1RA therapy, current capacity constraints necessitate a phased approach prioritising high-evidence or time-sensitive conditions. This framework provides a scientifically grounded and evidence-based model to support clinical decision-making and service development in obesity management. Continued research is warranted to expand the evidence base, optimise cost-effectiveness, and ensure equitable implementation of obesity pharmacotherapy within public health services. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and Challenges for Precision Nutrition in Gestational Obesity Management.","authors":"Emmie Söderström Shields, Nina Kaegi-Braun, Johanna Sandborg, Caroline Lilliecreutz, Marie Löf","doi":"10.1007/s13679-026-00710-x","DOIUrl":"10.1007/s13679-026-00710-x","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This review summarizes current knowledge on precision nutrition in gestational obesity management and outlines priorities for future research and implementation. RECENT FINDINGS: We summarize evidence on key factors (i.e., observable traits, social determinants of health, behavioral factors, clinical biomarkers, tissue-specific features, molecular-level data) that can be assessed and targeted within a precision nutrition approach for managing gestational obesity. Recent studies highlight obesity classes, behavioral-metabolic obesity phenotyping (hungry brain, emotional hunger, hungry gut) and the maternal metabolic milieu as interesting targets. Women’s and healthcare professionals’ (end-users) needs and perceptions as well as digital infrastructure requirements need further exploration. There is promise for more precision-based nutrition in optimizing gestational obesity management moving away from current one-size-fits all approaches. However, additional research is required to determine appropriate precision‑based nutrition approaches, evaluate their efficacy and cost‑effectiveness, and develop strategies for their implementation in routine care. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic and Bariatric Surgery: The Contraindications of the Past are the Indications of the Future.","authors":"Tala Abedalqader, Joseph Klim, Tony Boutros, Nour El Ghazal, Juan Ignacio Isaac, Andrew G Robertson, Mohammad Kermansaravi, Omar M Ghanem","doi":"10.1007/s13679-026-00711-w","DOIUrl":"10.1007/s13679-026-00711-w","url":null,"abstract":"<p><p>PURPOSE OF THE REVIEW: The global epidemic of obesity presents a challenge to physicians in all fields, as it impacts multiple organ systems and may hinder access to surgical or therapeutic interventions, yet reservations regarding referral for metabolic and bariatric surgery (MBS) persist. In this narrative review, we aimed to examine emerging evidence guiding the shift of what were once considered contraindications, to indications of MBS and to shed light on the future projections of MBS. RECENT FINDINGS: The technical advancements witnessed in the surgical field over the years, as well as the enhancement of preoperative and postoperative patient management, have contributed to significant improvement in the surgical outcomes of MBS. Coupled with the steadily growing body of evidence, the framework of patient selection has shifted and expanded. Additionally, MBS has been increasingly utilized to bridge to other interventions and to improve metabolic dysfunction, regardless of BMI. MBS has transitioned from being viewed as a last-resort intervention to an effective, evidence-based therapeutic modality for obesity and its related medical conditions. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Flux Adaptations During GLP-1 Receptor Agonist Therapy: Redox Implications.","authors":"Jaewang Lee, Ji Hyeon You, Hyun Jin Park, Jong-Lyel Roh, Sun Ha Paek","doi":"10.1007/s13679-026-00709-4","DOIUrl":"10.1007/s13679-026-00709-4","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: GLP-1 receptor agonists (GLP-1RAs) have become central therapies for obesity and metabolic disease. Although these agents produce substantial and sustained weight reduction, emerging clinical observations suggest that chronic therapy may be accompanied by changes in lean mass trajectory, reduced protein intake, and micronutrient insufficiency. This review examines metabolic adaptations during GLP-1RA therapy and their implications for nutritional and redox homeostasis. RECENT FINDINGS: GLP-1RA therapy maintains receptor signaling while reducing nutrient inflow, creating a physiological state of chronic energy flux constriction. Under these conditions, systemic metabolism increasingly relies on lipid-derived substrates and elevated oxidative throughput. When oxidative demand approaches the regenerative capacity of nicotinamide adenine dinucleotide (NAD⁺)/ nicotinamide adenine dinucleotide phosphate (NADPH; reduced form)-dependent buffering systems, several constraint-sensitive metabolic processes—including NAD⁺ partitioning, amino acid–dependent antioxidant–anabolic coupling, micronutrient-dependent enzymatic activity, and bile acid–mediated absorption—may become functionally limiting. Integrating emerging mechanistic and clinical observations, this review synthesizes current evidence from a metabolic flux perspective. This approach highlights how nutritional substrates and metabolic cofactors may influence physiological resilience during sustained pharmacological weight reduction. Clarifying these interactions may inform clinical monitoring strategies and nutritional management during long-term GLP-1RA therapy. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147590727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Scale: Setting Goals for Outcomes Beyond Weight in Evidence-based Obesity Treatment.","authors":"Leah M Schumacher, Jacqueline F Hayes, KayLoni L Olson, Samantha P Flanagan, Doria Wohler, Katherine E Darling","doi":"10.1007/s13679-026-00706-7","DOIUrl":"10.1007/s13679-026-00706-7","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: As definitions of obesity evolve beyond a sole focus on weight, evidence-based obesity treatments may also benefit from a broadening in focus. This review discusses benefits of setting goals with patients that expand beyond weight or anthropometric change, and reviews recent data on expected outcomes in four such domains where patients may often desire change: obesity-related diseases, health-related quality of life (HrQoL), body image, and weight bias internalization (WBI). RECENT FINDINGS: Lifestyle modification, obesity management medications, and metabolic and bariatric surgery can yield meaningful gains in obesity-related diseases, physical HrQoL, and body image. However, there is variability in response, and the expected magnitude of gains can differ by treatment approach and magnitude of weight loss. Less is known about WBI. Many patients are likely to see benefits beyond weight loss during treatment. Clarifying patients’ goals in these areas and aligning treatments accordingly can promote patient-centered care. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13035647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding Adipose Tissue Phenotypic Switching: From Mechanisms to Computational Drug Discovery.","authors":"Yuqing Ye, Ruxin Yin, Junjie Sun, Yuwei Dai, Di Zhao, Xiaoling Zou","doi":"10.1007/s13679-026-00701-y","DOIUrl":"10.1007/s13679-026-00701-y","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This review aims to explore the therapeutic potential of brown adipose tissue (BAT) to combat obesity and associated metabolic disorders by synthesizing the multifactorial influences and underlying mechanisms of BAT whitening and employing computational screening to identify promising candidate molecules for further investigation. RECENT FINDINGS: BAT whitening is characterized by the loss of thermogenic capacity, representing a critical aspect of adipose plasticity. Although diverse physiological and environmental triggers have been identified, the mechanistic interconnections underlying this process remain poorly understood. Emerging evidence supports an integrated view of these factors, and bioinformatic approaches now provide a valuable tool for the preliminary screening of potential intervention candidates. This review synthesizes current understanding on BAT whitening, from influencing factors to mechanistic pathways. Mitochondrial dysfunction appears to be a critical hub that could link diverse triggers to downstream metabolic and functional decline. Through bioinformatic screening, 4-hydroxybenzoic acid (4-HBA) is proposed as a candidate worthy of further study. Future work should prioritize experimental validation to clarify its mechanism and assess its translational potential. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the Potential Role of Spexin in Exercise-Induced Improvement of Cardiometabolic Health in Obesity and Diabetes.","authors":"Mei Yu, Xueshen Qian, Liang Wang, Chenhao Gu, Zhenwen Zhang, Wenbin Shang, Penghua Fang","doi":"10.1007/s13679-026-00704-9","DOIUrl":"10.1007/s13679-026-00704-9","url":null,"abstract":"<p><p>PURPOSE OF REVIEW: This review aims to summarize current knowledge of the intrinsic relationship between exercise, spexin, and cardiovascular diseases associated with obesity and diabetes and provide mechanistic insights into the beneficial effect of exercise on obesity, diabetes and cardiovascular diseases. RECENT FINDINGS: Emerging evidence indicates that spexin has been shown to be beneficial for diabetes and cardiometabolic health in preclinical models. In obese or diabetic states, circulating levels of spexin are significantly reduced, leading to skeletal muscle, the liver, and cardiac muscle becoming more susceptible to insulin resistance. Conversely, exercise triggers the release of spexin under obese or diabetic states, which may improve insulin resistance and cardiometabolic disorders. The mechanisms underlying the improvement of insulin resistance and cardiovascular disorders due to spexin involve increasing glucose uptake, fatty acid oxidation, and mitochondrial biogenesis, as well as reducing the mitochondrial oxidative stress in cardiac tissues. This review summarizes our recent studies and those of others to highlight the underlying molecular mechanisms of the effects of exercise induced spexin on diabetes and cardiovascular diseases. These insights shed new light on the pathophysiology of diabetes and cardiovascular disease based on preclinical studies and may provide useful clues for developing a combination of spexin and exercise as an effective therapeutic strategy for preventing or treating cardiometabolic disorders of obesity and diabetes. </p>","PeriodicalId":10846,"journal":{"name":"Current Obesity Reports","volume":"15 1","pages":""},"PeriodicalIF":17.0,"publicationDate":"2026-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}