International Journal of Obesity最新文献

{"title":"Endocrine regulation of metabolic crosstalk between liver and brown adipose tissue by natural active ingredients.","authors":"Qi-Cong Chen, Wei-Feng Cai, Qian Ni, Song-Xia Lin, Cui-Ping Jiang, Yan-Kui Yi, Li Liu, Qiang Liu, Chun-Yan Shen","doi":"10.1038/s41366-025-01793-7","DOIUrl":"10.1038/s41366-025-01793-7","url":null,"abstract":"<p><p>The escalating global obesity crisis and its associated metabolic disorders have posed a significant threat to public health, increasing the risk of major health issues such as cardiovascular diseases and type 2 diabetes. Central to metabolic regulation are the liver and brown adipose tissue (BAT), which orchestrate glycolipid metabolism, thermogenesis, and energy homeostasis. Emerging evidence highlights the role of natural bioactive compounds-such as polyphenols (e.g., resveratrol, curcumin), alkaloids (e.g., berberine), and terpenoids (e.g., paeoniflorin, shikonin)-in modulating liver-BAT crosstalk. These compounds influence critical pathways, including AMPK activation, PPAR signaling, and UCP1-mediated thermogenesis, to enhance lipid oxidation, suppress gluconeogenesis, and improve insulin sensitivity. This review systematically examines how these natural agents regulate metabolic interplay between the liver and BAT, addressing their effects on energy expenditure, carbohydrate utilization, and lipid mobilization. Key mechanisms involve the suppression of hepatic lipogenesis, promotion of BAT-mediated thermogenesis, and secretion of hepatokines (e.g., FGF21) and batokines that coordinate interorgan communication. By synthesizing preclinical and clinical findings, we highlight the translational potential of dietary interventions and nutraceuticals targeting liver-BAT axis dysfunction. Future research should prioritize mechanistic studies, dose optimization, and personalized approaches to harness these compounds for combating obesity-related diseases. These insights underscore the promise of natural bioactive molecules as adjuvants to lifestyle modifications, offering innovative strategies for metabolic health restoration.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101661","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":"Obesity medications in patients with recurrent weight gain or suboptimal clinical response following bariatric surgery: a meta-analysis.","authors":"Mahdieh Golzarand, Karamollah Toolabi, Parvin Mirmiran","doi":"10.1038/s41366-025-01807-4","DOIUrl":"https://doi.org/10.1038/s41366-025-01807-4","url":null,"abstract":"<p><strong>Background: </strong>Postoperative recurrent weight gain or suboptimal clinical response are important concerns; however, there is no consensus regarding the use of pharmacotherapy to manage weight after bariatric surgery. Hence, it is reasonable to combine the available data to provide a practical guideline for clinicians about the administration of obesity medications for patients with recurrent weight gain or suboptimal clinical response after bariatric surgery.</p><p><strong>Methods: </strong>We conducted a search of electronic databases, including Scopus, PubMed/Medline, and the Web of Science, up to December 2024. The eligible studies included randomized controlled trials or retrospective studies that assessed the effects of obesity medications on weight, body mass index (BMI), or percentage total weight loss (%TWL) in patients experiencing recurrent weight gain or a suboptimal clinical response following bariatric surgery.</p><p><strong>Results: </strong>This meta-analysis reviewed 26 relevant studies and demonstrated that glucagon-like peptide-1 (GLP-1) receptor agonists reduced weight by 8.38 kg (95% CI: -9.68 to -7.08) and BMI by 3.76 kg/m² (95% CI: -4.50 to -3.01). The overall %TWL was 9.94% (95% CI: 8.34 to 11.53). After subgroup analysis, we found that the effect of semaglutide on %TWL was significantly greater than that of liraglutide. In terms of non-GLP-1 receptor agonists, patients achieved a weight loss of 2.97 kg (95% CI: -4.00 to -1.95), a BMI loss of 1.41 kg/m² (95% CI: -2.28 to -0.53), and a % TWL of 4.50% (95% CI: 2.86 to 6.15). The subgroup analysis suggested that combination therapy had more pronounced effects on outcomes than monotherapy.</p><p><strong>Conclusion: </strong>Our results indicated that obesity medications may be an effective adjunctive therapy to maintain weight loss post-bariatric surgery.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093597","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":"The intensity of exercise and inflammation markers in women with overweight & obesity: a systematic review and network meta-analysis.","authors":"Liang Tan, Duo Huang, Bo Liu, Zbigniew Ossowski, Ning Wang, Weihua Yan","doi":"10.1038/s41366-025-01777-7","DOIUrl":"https://doi.org/10.1038/s41366-025-01777-7","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this network meta-analysis (NMA) of randomized controlled trials (RCT) was to examine the effects of different exercise intensities on inflammatory markers in women with overweight/obesity.</p><p><strong>Methods: </strong>A systematic search for RCTs that met the inclusion criteria for the period up to October 2024. random effects NMA was performed within a frequency-based framework.</p><p><strong>Results: </strong>A total of 75 RCTs were included (3989 participants). High-intensity exercise significantly modulated leptin and adiponectin levels, but had a nonsignificant effect on TNF-α, CRP, and IL-6 levels. Moderate-intensity exercise significantly modulated TNF-α, CRP, IL-6, leptin, and adiponectin levels. Surface under the cumulative ranking curve (SUCRA) probability ranking showed that moderate-intensity exercise was the most recommended exercise intensity for reducing TNF-α, CRP, IL-6, and leptin levels, and for modulating adiponectin levels, moderate-intensity exercise also had a SUCRA value of 65.4%, so we believe that moderate-intensity exercise may be the most robust type of exercise intensity in terms of the breadth of effects. Subgroup analysis showed that moderate-intensity aerobic exercise (MAE) significantly reduced TNF-α levels. Moderate-intensity resistance training (MRT) is the most recommended type for decreasing IL-6 and leptin levels. Moderate-intensity combined exercise (MCE) is the best type of exercise for managing CRP and adiponectin levels.</p><p><strong>Conclusions: </strong>There were significant differences in the effects of different exercise intensities on specific inflammatory markers in women living with overweight and obesity. Moderate-intensity exercise may be the most robust type of exercise intensity. Future studies should consider the importance of exercise duration and volume (e.g., in MET* minutes/week) to better understand the relationship between exercise intensity and inflammatory markers. The effects of combining exercise and diet on inflammatory markers in women with overweight and obesity should also be explored in greater depth.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086209","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":"Real -world experience with anti-obesity medications treatment in children and adolescents with overweight and obesity in Israel.","authors":"Shlomit Shalitin, Moshe Phillip, Michal Yackobovitch-Gavan","doi":"10.1038/s41366-025-01801-w","DOIUrl":"https://doi.org/10.1038/s41366-025-01801-w","url":null,"abstract":"<p><strong>Background: </strong>Childhood obesity is a major public health concern, associated with early-onset comorbidities and a high likelihood of persisting into adulthood. Anti-obesity medications (AOMs) may serve as an adjunct to lifestyle modifications for managing pediatric obesity.</p><p><strong>Objective: </strong>To evaluate prescribing patterns, weight outcomes, and cardiometabolic impacts of AOMs among children and adolescents aged 10-18 years within Clalit Health Services (CHS), the largest health maintenance organization in Israel.</p><p><strong>Subjects/methods: </strong>This retrospective observational study analyzed data from CHS's electronic database (2017-2024). The study cohort included 307 208 children with BMI measurements exceeding World Health Organization (WHO)-defined thresholds for overweight or obesity. Among these, 2236 (0.7%) were prescribed AOMs (metformin, GLP-1 receptor agonist, or orlistat). A secondary analysis assessed longitudinal changes in BMI z-scores and cardiometabolic parameters among individuals who purchased at list two prescriptions of AOMs.</p><p><strong>Results: </strong>AOMs prescriptions were more common among females, younger patients, those with higher BMI z-scores, and medium-to-high socioeconomic position (SEP) levels. Children prescribed AOMs exhibited a higher prevalence of obesity-related comorbidities and greater engagement with dietitians and endocrine specialists. Metformin was the most commonly prescribed medication (73.8%), followed by GLP-1 receptor agonist (24.5%) and orlistat (1.7%). Females demonstrated higher rates of medication adherence and longer treatment durations than males. Among the 1717 participants with ≥2 AOMs purchases, BMI z-scores significantly declined during treatment, accompanied by reductions in blood glucose, HbA1c, triglycerides, and total cholesterol, and increases in HDL cholesterol. BMI z-scores and cardiometabolic parameters partially regressed after treatment cessation but remained improved compared to baseline.</p><p><strong>Conclusions: </strong>AOMs demonstrate potential for weight management and cardiometabolic improvement in children with obesity, particularly among those with severe obesity and comorbidities, within real-world settings. However, the modest utilization rate highlights the need for improved accessibility and further real-world evidence to optimize treatment strategies for pediatric obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144077965","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":"Impact of other macronutrient composition within high-protein diet on body composition and cardiometabolic health: a systematic review, pairwise, and network meta-analysis of randomized controlled trials.","authors":"Yueying Yao, Shiqi Lin, Ziqi He, Jung Eun Kim","doi":"10.1038/s41366-025-01806-5","DOIUrl":"https://doi.org/10.1038/s41366-025-01806-5","url":null,"abstract":"<p><strong>Background/obejctive: </strong>Although the high-protein diets (HPDs) on weight control and body composition management are well investigated, mix results have been reported across studies and this variability may be attributed to differences in the composition of other macronutrients within HPDs. The aim of this study was to evaluate the impacts of HPDs with varied macronutrient compositions on body composition and cardiometabolic health outcomes through a systematic review, pairwise, and network meta-analysis.</p><p><strong>Methods: </strong>A comprehensive search of four databases (PubMed, Embase, CINAHL, and Web of Science) was conducted to identify relevant randomized controlled trials. A total of 83 articles were selected for systematic review and both meta-analyses.</p><p><strong>Results: </strong>Significant reduction in body mass (BM) (standardized mean difference [SMD] = -0.25; 95% CI: -0.40, -0.11), body mass index (BMI) (SMD = -0.26; 95% CI: -0.38, -0.15), waist circumference (WC) (SMD = -0.19; 95% CI: -0.33, -0.04), fat mass (FM) (mean difference [MD] = -0.64 kg; 95% CI: -0.98, -0.29), along with increase in lean body mass (LBM) (MD = 0.34 kg; 95% CI: 0.11, 0.57) were observed with HPDs regiments compared to normal-protein diets. Specifically, the high-protein, moderate-carbohydrate and high-fat diet ranked the best in reducing BM, BMI, WC, FM, systolic blood pressure, diastolic blood pressure and increasing LBM; while the high-protein, low-carbohydrate and high-fat diet obtained the highest score in reducing triglyceride and increasing high-density lipoprotein cholesterol.</p><p><strong>Conclusion: </strong>HPDs effectively reduce FM and increase LBM, and offers potential cardiometabolic benefits. Additionally, the manipulation of carbohydrate content in HPDs may further influence these outcomes.</p><p><strong>Registration: </strong>PROSPERO (CRD42023483907).</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995527","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":"Evaluating the obesity paradox in patients with sepsis and cancer.","authors":"Chunhong Hou, Yu Qi, Tuo Zhang, Ya Liu, Jingli Wu, Wenting Li, Jiaqi Li, Xia Li","doi":"10.1038/s41366-025-01805-6","DOIUrl":"https://doi.org/10.1038/s41366-025-01805-6","url":null,"abstract":"<p><strong>Background: </strong>The obesity paradox, where higher body mass index (BMI) is associated with improved survival, is observed in sepsis and cancer individually. However, its effect in patients with both conditions is unclear. The objective of this study is to evaluate the obesity paradox in intensive care unit (ICU) patients with sepsis and cancer and examine whether BMI's impact on mortality varies across patient phenotypes.</p><p><strong>Methods: </strong>Data from the Medical Information Mart for Intensive Care IV database were analyzed. Patients were categorized by BMI into underweight (<18.5 kg/m², n = 173), normal weight (18.5-24.9 kg/m², n = 1283), overweight (25-29.9 kg/m², n = 1498), and obesity (≥30 kg/m², n = 960). The primary outcome was 28-day mortality, with secondary outcomes including 6-month mortality, 1-year mortality, length of ICU stay, continuous renal replacement therapy usage, and invasive ventilation usage. Multivariable logistic regression and restricted cubic splines were used to explore the BMI-mortality relationship, and unsupervised clustering was performed to identify patient phenotypes.</p><p><strong>Results: </strong>Among 3914 patients, obesity was associated with lower mortality. Clustering revealed four distinct phenotypes, with the protective effect of obesity being more evident in patients with lower Sequential Organ Failure Assessment (SOFA) scores (Cluster1, Cluster2 and Cluster3).</p><p><strong>Conclusions: </strong>The obesity paradox is evident in both short-term outcome (28-day mortality) and long-term outcomes (6-month and 1-year mortality) among patients with sepsis and cancer, particularly in those presenting with lower disease severity. These findings highlight the need for personalized treatment approaches in this complex patient population.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980439","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":"Determining the interplay of prenatal parental BMI in shaping child BMI trajectories: the CHILD Cohort Study.","authors":"Antonio Rossi, Zheng Hao Chen, Mojtaba Ahmadiankalati, Susan C Campisi, Myrtha E Reyna, Kendra Dempsey, David Jenkins, Deborah O'Connor, Ahmed El-Sohemy, Piushkumar J Mandhane, Elinor Simons, Stuart E Turvey, Theo J Moraes, Zihang Lu, Padmaja Subbarao, Kozeta Miliku","doi":"10.1038/s41366-025-01792-8","DOIUrl":"https://doi.org/10.1038/s41366-025-01792-8","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major public health concern affecting millions of people globally. Early identification of individuals susceptible to obesity is crucial for reducing the burden of obesity. Obesity is often defined based on body-mass-index (BMI), and tracking BMI trajectories from early childhood offers a valuable tool for risk stratification. Although the role of mothers in shaping these trajectories is well-recognized, the paternal influence on childhood obesity development remains a knowledge gap. We hypothesize that children of fathers with obesity have higher odds of being in the rapid BMI growth trajectory with stronger estimates when the mother is also with overweight or obesity.</p><p><strong>Methods: </strong>We analyzed data from the Canadian CHILD Cohort Study, a pregnancy cohort in which both parents were enrolled in early pregnancy when BMI was assessed. The child's BMI was repeatedly collected from birth to age five. We used group-based trajectory modeling to identify offspring BMI z-score (BMIz) trajectory groups (age-and-sex standardized) and weighted multinomial logistic regression analysis to determine the associations between prenatal paternal BMI and offspring growth trajectories, stratified by maternal weight categories.</p><p><strong>Results: </strong>Among 2 238 participants, the mean prenatal paternal BMI was 27.44 (SD = 4.77), and 22.83% of fathers were with obesity. The four identified offspring BMIz trajectories were: low stable (n = 220, 9.83%), normative (n = 1 356, 60.59%), high stable (n = 572, 25.56%), and rapid BMIz growth trajectory (n = 90, 4.02%). Children of normal-weight mothers and fathers with obesity had 1.86 higher odds (OR: 1.86; 95%CI: 1.22-2.84) of being classified in the rapid growth BMIz trajectory, compared to children of normal-weight fathers. The odds of being in the rapid growth BMIz trajectory were higher when both mothers and fathers were with obesity (OR: 4.35; 95%CI: 2.65-7.14).</p><p><strong>Conclusions: </strong>Children of fathers with obesity had higher odds of being in the rapid BMI growth trajectory, particularly when also the mother was with overweight or obesity. These results support the need for preconception advice and interventions for couples to optimize their offspring's health.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004171","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":"Does weighted vest use during weight loss influence long-term weight loss maintenance? A pilot study in older adults living with obesity and osteoarthritis.","authors":"Carson DeLong, Barbara J Nicklas, Daniel P Beavers, Jason Fanning, Kristen M Beavers","doi":"10.1038/s41366-025-01795-5","DOIUrl":"10.1038/s41366-025-01795-5","url":null,"abstract":"<p><p>The purpose of this study was to explore whether and how gravitational loading during intentional weight loss (WL) influences subsequent weight regain. Pilot data come from a convenience sample of 18 older adults (70.4 ± 3.1 years, 83% women, 78% white) with obesity who participated in a 6-month WL intervention and also returned for 24-month follow-up assessment. Participants were originally assigned to 6-months of caloric restriction plus 10 h/day weighted vest use (WL+VEST; n = 9) or caloric restriction only (WL Only; n = 9). Body weight (BW) and resting metabolic rate (RMR) were collected at baseline, 6, and 24 months. WL+VEST and WL Only participants lost significant and similar amounts of BW by 6-months [WL+VEST: -11.2 kg (95% CI: -14.6, -7.7) versus WL Only: -10.3 kg (95% CI: -13.7, -6.8)]; p = 0.71. By 24-months, the WL+VEST group regained approximately half of lost BW [-4.8 kg from baseline (95% CI: -9.6, 0.1)], while the WL Only group regained all lost BW [+0.9 kg from baseline (95% CI: -3.9, 5.8)]; p = 0.10. Change in RMR from baseline to 6 months was -16.3 (95% CI: -100.8, 68.2) kcal/day and -237.5 (95% CI: -321.9, -153.0) kcal/day for the WL+VEST and WL Only groups, respectively (p < 0.01); and was modestly and inversely associated with change in BW from 6 to 24 months (r = -0.39, p = 0.11). Pilot data signal weighted vest use during caloric restriction may be associated with reduced weight regain via preserved RMR. Study Overview and Results. Created with BioRender.com.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995659","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":"Evaluating population attributable fractions of cardiovascular diseases in relation to 20-year body mass index; the ATTICA study (2002-2022).","authors":"Evangelia Damigou, Costas Anastasiou, Christina Chrysohoou, Fotios Barkas, Evangelos Liberopoulos, Christos Pitsavos, Costas Tsioufis, Petros P Sfikakis, Demosthenes Panagiotakos","doi":"10.1038/s41366-025-01796-4","DOIUrl":"https://doi.org/10.1038/s41366-025-01796-4","url":null,"abstract":"<p><strong>Background/objectives: </strong>The growing prevalence of overweight and obesity globally highlights the need to reconsider the thresholds for defining excess body weight, especially as the health risks associated with weight gain continue to impact population health metrics. This study aimed to evaluate the population attributable fraction (PAF) and prevented fraction for the population (PFP) of CVD cases by body weight trajectories over a 20-year period (2002-2022).</p><p><strong>Subjects/methods: </strong>The studied population-based sample was 1348 individuals (39(10) years old, 48% males), initially free-of-CVD, from the ATTICA cohort study (2002-2022). Combined fatal/non-fatal CVD outcomes were evaluated; body weight and height measurements were performed in 2002, 2012, and 2022 examinations, following standard procedures. Body weight trends, based on cumulative average BMI during 2002-2022, were also calculated. PAF and PFP were computed.</p><p><strong>Results: </strong>Twenty-nine percent (95%Confidence Interval: 22%, 35%) of CVD cases were prevented by maintaining a normal body weight status during 2002-2022. If increased BMI (>25 kg/m²) had been eliminated, 30% (8.7%, 38%) of CVD cases would have been prevented. Three-times more CVD cases would have been prevented if overweight had been managed compared to if obesity had been managed [i.e., 23% (5.1%, 29%) vs 7.2% (1.1%, 9.1%), respectively]. Variations of the PAFs and PFPs were observed by sex, age group, Mediterranean diet adherence, physical activity status, presence of comorbidities, and anxiety trajectories.</p><p><strong>Conclusions: </strong>Future public health actions should not neglect to also include people with overweight for the effective management of body weight, which can offer significant long-term benefits for cardiovascular health. A graphical representation of the main study findings on population prevented and attributable fractions by long-term body weight status (n = 1348); the ATTICA study (2002-2022). CVD cardiovascular disease.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008075","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":"Uncovering key factors in weight loss effectiveness through machine learning.","authors":"Hui-Wen Yang, Rocío De la Peña-Armada, Haoqi Sun, Yu-Qi Peng, Men-Tzung Lo, Frank A J L Scheer, Kun Hu, Marta Garaulet","doi":"10.1038/s41366-025-01766-w","DOIUrl":"https://doi.org/10.1038/s41366-025-01766-w","url":null,"abstract":"<p><strong>Background/objectives: </strong>One of the main challenges in weight loss is the dramatic interindividual variability in response to treatment. We aim to systematically identify factors relevant to weight loss effectiveness using machine learning (ML).</p><p><strong>Subjects/methods: </strong>We studied 1810 participants in the ONTIME program, which is based on cognitive-behavioral therapy for obesity (CBT-OB). We assessed 138 variables representing participants' characteristics, clinical history, metabolic status, dietary intake, physical activity, sleep habits, chronotype, emotional eating, and social and environmental barriers to losing weight. We used XGBoost (extreme gradient boosting) to predict treatment response and SHAP (SHapley Additive exPlanations) to identify the most relevant factors for weight loss effectiveness.</p><p><strong>Results: </strong>The total weight loss was 8.45% of the initial weight, the rate of weight loss was 543 g/wk., and attrition was 33%. Treatment duration (mean ± SD: 14.33 ± 8.61 weeks) and initial BMI (28.9 ± 3.33) were crucial factors for all three outcomes. The lack of motivation emerged as the most significant barrier to total weight loss and also influenced the rate of weight loss and attrition. Participants who maintained their motivation lost 1.4% more of their initial body weight than those who lost motivation during treatment (P < 0.0001). The second and third critical factors for decreased total weight loss were lower \"self-monitoring\" and \"eating habits during treatment\" (particularly higher snacking). Higher physical activity was a key variable for the greater rate of weight loss.</p><p><strong>Conclusions: </strong>Machine learning analysis revealed key modifiable lifestyle factors during treatment, highlighting avenues for targeted interventions in future weight loss programs. Specifically, interventions should prioritize strategies to sustain motivation, address snacking behaviors, and enhance self-monitoring techniques. Further research is warranted to evaluate the efficacy of these strategies in improving weight loss outcomes.</p><p><strong>Trial registration: </strong>clinicaltrials.gov: NCT02829619.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995307","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}