International Journal of Obesity最新文献

{"title":"Satiety does not always silence attention to high-calorie foods: BMI modulates food-related attentional bias.","authors":"Marc Ballestero-Arnau, Borja Rodríguez-Herreros, Toni Cunillera","doi":"10.1038/s41366-026-02240-x","DOIUrl":"https://doi.org/10.1038/s41366-026-02240-x","url":null,"abstract":"<p><strong>Background: </strong>Attentional bias (AB) for palatable foods has been linked to overeating, yet data on its modulation with body-mass index (BMI) and hunger/satiety are inconsistent. We tested whether hunger, sensory-specific satiety and BMI interact to shape automatic capture of attention by real high-calorie foods.</p><p><strong>Methods: </strong>Two emotional-attentional-blink (EAB) experiments presented food distractors either 300 ms (lag-3) or 900 ms (lag-9) before a neutral target. Experiment 1 (N = 183; whole BMI range) randomly assigned participants to taste (non-satiated), satiated or non-eating conditions; the snacks eaten (or not eaten) subsequently re-appeared as distractors in the EAB task. Experiment 2 (N = 61; 31 overweight/obese, 30 normal-weight) manipulated hunger/satiety states and snack type (consumed vs. novel) orthogonally, in a double session design.</p><p><strong>Results: </strong>Experiment 1-food images presented at lag-3 reduced target detection compared with lag-9 (OR = 0.61, CI 0.50-0.75, p < 0.01). Higher BMI predicted a larger AB when hungry, but a smaller AB when satiated (OR = 0.65, CI 0.48-0.88, p < 0.01). Experiment 2-For novel foods, an interaction revealed that participants with overweight/obesity retained robust AB after satiation, whereas AB declined for participants with normal-weight (OR = 2.45, CI 1.09-5.51, p = 0.03). For snacks just eaten, AB remained significant in both groups (lag-3 vs. lag-9: OR = 0.37, CI 0.25-0.55, p < 0.001).</p><p><strong>Conclusions: </strong>Real-food cues automatically biased attention regardless of metabolic state, with BMI modulating this effect: even when satiated, individuals with overweight/obesity continue to orient their attention toward both familiar and novel high-calorie foods. These findings suggest that satiety signals alone may be insufficient to curb attentional capture by food in obesity, highlighting the need for interventions that target attentional control and limit food availability.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109296","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":"Is obesity awareness related to anthropometric measures or sociocultural factors?","authors":"Gulsum Tikac, Seref Duhan Altug, Ayse Unal","doi":"10.1038/s41366-026-02238-5","DOIUrl":"https://doi.org/10.1038/s41366-026-02238-5","url":null,"abstract":"<p><strong>Background: </strong>Obesity, a major global health problem in terms of morbidity and mortality, is prompting research into the relationship between changing anthropometric measurements and awareness levels. The aim of our study was to examine whether obesity awareness is associated with anthropometric characteristics or sociocultural and behavioral characteristics.</p><p><strong>Methods: </strong>A total of 123 adult volunteers (aged 30-60) were stratified into groups with normal weight (n = 37), overweight (n = 44), and obesity (n = 42). In addition to sociodemographic data (age, sex, smoking, exercise, profession, etc.) that may affect the development of obesity, anthropometric measurements (BMI, waist-hip ratio, waist-to-height ratio) were taken from the participants. An obesity awareness scale was used to assess levels of awareness.</p><p><strong>Results: </strong>Anthropometric measurements showed no correlation with the overall obesity awareness scale. However, within the awareness subscale, the group with overweight scored significantly higher than the group with obesity (p = 0.005). We also observed significant correlations among the anthropometric metrics themselves. In multivariable regression analysis adjusting for baseline sociodemographic confounders, BMI showed no independent association with overall obesity awareness (p = 0.928). Furthermore, our analysis of sociodemographic and behavioral factors revealed that the presence of a family member (p = 0.025) with obesity and occupational status (p = 0.002) significantly were significantly associated with obesity awareness.</p><p><strong>Conclusion: </strong>The sum of these findings indicates that in this cross-sectional sample, obesity awareness did not significantly correlate with objective anthropometric measures.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108974","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, sleep apnea and cancer revisited.","authors":"M Sánchez-de-la-Torre, D Gozal","doi":"10.1038/s41366-026-02230-z","DOIUrl":"https://doi.org/10.1038/s41366-026-02230-z","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA), obesity, and cancer constitute an interconnected pathophysiological triad withi mportant implications for morbidity and mortality. Obesity is a major upstream driver of both OSA and tumorigenesis, while OSA contributes independently through intermittent hypoxia, sleep fragmentation, systemici nflammation, oxidative stress, immune dysregulation, and sympathetic activation. Emerging evidence links OSA-associated hypoxemia to cancer initiation, progression, and treatment response, with hypoxic burden and nocturnal oxygen desaturation metrics outperforming the apnea-hypopnea index in predicting cancer-related outcomes. Mechanistic advances implicate immune checkpoint signaling, extracellular matrix remodeling, and metabolic-hepatic pathways as key mediators of OSA-related oncogenesis. Epidemiological studies support associations between OSA and several malignancies independent of obesity, although residual confounding remains a challenge. Therapeutically, continuous positive airway pressure may mitigate hypoxemia-related pathways, whereas bariatric surgery and GLP-1/GIP receptor agonists off er the potential to simultaneously reduce obesity, OSA severity, and cancer risk. Precision medicine approaches integrating hypoxemia phenotyping, immune profi ling, and targeted interventions are needed to optimize prevention and treatment strategies.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109249","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":"Physiology of the Weight Reduced State (POWERS) Collection","authors":"David Stensel","doi":"10.1038/s41366-026-02219-8","DOIUrl":"10.1038/s41366-026-02219-8","url":null,"abstract":"","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"50 9","pages":"1857-1857"},"PeriodicalIF":5.4,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-026-02219-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080800","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":"Indirect comparative efficacy and safety of tirzepatide vs semaglutide for the treatment of obesity or overweight in patients without type 2 diabetes.","authors":"Andreea Ciudin, Erin Johansson, Sarah Zimner-Rapuch, Georgios K Dimitriadis, Marine Bertrand, Tristan Curteis, Laura J Clark, Ludi Fan, Helene Sapin, Jean-Francois Bergmann","doi":"10.1038/s41366-026-02229-6","DOIUrl":"https://doi.org/10.1038/s41366-026-02229-6","url":null,"abstract":"<p><strong>Background/objectives: </strong>Tirzepatide is a once-weekly, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist (RA) for obesity treatment. This indirect treatment comparison (ITC) assessed the relative efficacy and safety of tirzepatide versus the GLP-1 RA semaglutide.</p><p><strong>Subjects/methods: </strong>Adjusted (for sex, and sex and ethnicity) and unadjusted ITCs compared tirzepatide 5, 10, and 15 mg/week and semaglutide 2.4 mg/week via placebo, all adjunct to reduced-calorie diet and increased physical activity, at primary trial endpoints (Week 68, STEP 1; Week 72, SURMOUNT-1) for adults with obesity (BMI ≥ 30 kg/m²), or overweight (BMI ≥ 27 kg/m²) with ≥1 obesity-related complication (ORC), without type 2 diabetes (T2D).</p><p><strong>Results: </strong>For efficacy estimand unadjusted ITCs, tirzepatide 10 and 15 mg demonstrated statistically significant improvements versus semaglutide in weight reduction (-5.10 kg [-6.63, - 3.57], -6.50 kg [-8.03,-4.97]), participants achieving ≥10/15/20% weight reduction, BMI (-1.87 kg/m² [-2.43,-1.31], -2.37 kg/m² [-2.93,-1.81]), waist circumference (-5.25 cm [-6.69,-3.81], -5.75 cm [-7.19,-4.31]), HbA1c(-0.08% [-0.13,-0.03], -0.10% [-0.15, -0.05]) and fasting plasma glucose (-1.69 mg/dL [-3.36,-0.02], -2.52 mg/dL [-4.19,-0.85]). Tirzepatide 5 mg showed non-significant trends of greater improvements in these outcomes versus semaglutide. All tirzepatide doses showed statistically significantly greater decreases in diastolic blood pressure (-1.90 mmHg [-3.19,-0.61], -2.40 mmHg [-3.69,-1.11], -1.30 mmHg [-2.59,-0.01]) and increases in HDL (3.80% [1.23,6.37], 5.40% [2.83,7.97], 5.00% [2.43,7.57]). In participants reporting on body composition, tirzepatide 15 mg demonstrated statistically significant improvements in body composition versus semaglutide, with a reduction of percentage body fat mass (-3.50% [-6.66, -0.34]) and an increase of percentage body lean mass (3.40% [0.40, 6.40]). Results were broadly consistent across adjusted and unadjusted comparisons. Safety profiles of tirzepatide and semaglutide were generally similar.</p><p><strong>Conclusions: </strong>In this ITC for obesity treatment in adults without T2D, with obesity, or overweight with ≥1 ORC, compared with semaglutide, tirzepatide 10 or 15 mg was associated with improvements in weight reduction, body composition and several cardiometabolic risk factors and generally similar safety profiles.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074597","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":"Bidirectional crosstalk between obesity and the lymphatic system: a novel pathway in obesity pathogenesis and treatment.","authors":"Yitong Hao, Yutong Zhang, Jiamin Zong, Gaomin Wu, Yu Wang, Junhong Wang, Yanyan Wang","doi":"10.1038/s41366-026-02178-0","DOIUrl":"https://doi.org/10.1038/s41366-026-02178-0","url":null,"abstract":"<p><p>Obesity has become a global public health crisis in recent years, with its continuous rise posing significant health risks. It is associated with a range of chronic diseases, including cardiovascular disease, type 2 diabetes, and certain types of cancer. Additionally, obesity leads to poor health outcomes and reduces life expectancy. The lymphatic system, a critical part of the circulatory system, has traditionally been recognized for its primary functions in immune surveillance and maintaining tissue fluid balance. Lymphatics also play a more complex role in lipid metabolism, immune regulation, and inflammation control, which significantly influences metabolic health. Despite these insights, the specific mechanisms of interaction between lymphatic dysfunction and obesity, as well as the directionality of causality, are not yet fully understood. This review aims to systematically synthesize and evaluate existing evidence regarding the interrelationship between lymphatic dysfunction and obesity. Its goal is to provide novel perspectives for developing innovative preventative and therapeutic strategies targeting lymphatic function in obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061268","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 dysfunction-associated steatotic liver disease-a review of the cardiometabolic perspectives and treatments in children.","authors":"Katherine McGoogan, Vijay Hegde, Justin Wilburn, Felicia Cooper, Shilpa Gurnurkar, Wagner L Prado, P Babu Balagopal","doi":"10.1038/s41366-026-02101-7","DOIUrl":"https://doi.org/10.1038/s41366-026-02101-7","url":null,"abstract":"<p><p>The rising prevalence of childhood obesity is closely linked to the early onset of comorbid conditions, notably metabolic dysfunction-associated steatotic liver disease (MASLD), a hepatic manifestation of metabolic syndrome characterized by hepatic steatosis in the absence of significant alcohol intake. The pathophysiology of MASLD includes complex interactions among various factors such as hormonal, genetic, lifestyle and nutritional, and environmental dynamics. Emerging evidence indicates that MASLD is independently associated with a higher risk of cardiovascular disease (CVD), irrespective of traditional CV-risk factors such as hypertension, dyslipidemia, and diabetes mellitus. A comprehensive, multipronged approach is central to the detection, monitoring, and management of MASLD and associated adverse cardiovascular outcomes in children. Currently, there are no approved medications or other specific therapies for pediatric MASLD. While early stages of the disease are potentially reversible through lifestyle modifications, including diet/nutrition and physical activity, these strategies are often difficult to implement and sustain over time. Early detection of progression of MASLD to more severe conditions is hampered by the lack of reliable noninvasive methods of risk assessment tools. The objective of this review is to (1) succinctly summarize the relationship between MASLD and CVD risk in children and (2) discuss advances in MASLD management and treatment in children. We believe that this article will stimulate new avenues for research into MASLD and its broader cardiometabolic implications in pediatric populations.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030468","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":"Revealing genetic foundations underlying cardiometabolic traits: integrating twin and GWAS data in Asian populations.","authors":"Xuanming Hong, Ming Li, Weihua Cao, Jun Lv, Canqing Yu, Tao Huang, Dianjianyi Sun, Chunxiao Liao, Yuanjie Pang, Runhua Hu, Ruqin Gao, Min Yu, Jinyi Zhou, Xianping Wu, Yu Liu, Shengli Yin, Wenjing Gao, Liming Li","doi":"10.1038/s41366-026-02209-w","DOIUrl":"https://doi.org/10.1038/s41366-026-02209-w","url":null,"abstract":"<p><strong>Background: </strong>Traditional twin studies have reported high heritability estimates for common cardiometabolic traits, yet discrepancies compared to genome-wide association studies (GWAS) derived estimates underscore the effects of \"missing heritability\", potentially attributed to genetic interactions and environmental influences. However, research exploring potential contributors to missing heritability in cardiometabolic phenotypes remains scarce and largely confined to European populations.</p><p><strong>Methods: </strong>We analyzed twin data (n = 2548) from the Chinese National Twin Registry (CNTR) and GWAS summary-level data (n = 92,615) from Asian cohorts to estimate the heritability of 10 cardiometabolic traits: BMI, waist-to-hip ratio (WHR), hemoglobin A1c (HbA1c), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). Using a twin study design, we quantified dominance genetic effects and explored gene-environment interactions involving age, lifestyle, and psychosocial factors on these traits. Additionally, we leveraged both twin and GWAS data to investigate genetic correlations between cardiometabolic traits, revealing shared genetic underpinnings.</p><p><strong>Results: </strong>Twin data revealed moderate to high heritability estimates (0.34-0.72) for cardiometabolic traits, whereas GWAS data yielded lower estimates (0.10-0.22). Dominant genetic variance was statistically significant only for BMI (0.42), suggesting a limited role for dominance across most cardiometabolic traits examined in this study. No evidence of non-additive effects was observed in GWAS summary statistics. Gene-environment interaction analyses identified 12 small yet significant interaction effects involving age, smoking, drinking, education, and mental health. Finally, genetic correlations between pairs of cardiometabolic traits ranged from low to high (0.09-0.90), with broadly consistent patterns observed across twin and GWAS approaches.</p><p><strong>Conclusions: </strong>These findings collectively advance our understanding of the genetic architecture underlying cardiometabolic traits and their interrelationships in Asian populations.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024835","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":"Influence of Lactobacillus plantarum on anthropometric and inflammatory parameters in obesity: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials.","authors":"Muhammad Huzaifa Khattak, Syed Aqeel Abbas, Umer Zaryab, Humaira Bibi, Shahreena Athar Siddiqui, Bilal Wazir Khan, Nafila Zeeshan, Muhammad Faaz Khan, Muhammad Maaz Amjad, Naveed Ahmad Khan, Yasir Mehmood, Haris Wazir Khan","doi":"10.1038/s41366-026-02221-0","DOIUrl":"https://doi.org/10.1038/s41366-026-02221-0","url":null,"abstract":"<p><strong>Background: </strong>The global obesity epidemic, rooted in chronic inflammation and metabolic dysfunction, necessitates novel interventions; however, evidence regarding the efficacy of Lactobacillus plantarum remains inconsistent.</p><p><strong>Objective: </strong>To evaluate the impact of L. plantarum on obesity-related outcomes in adults via a systematic review and meta-analysis of RCTs.</p><p><strong>Methods: </strong>Following PRISMA guidelines and registered in PROSPERO (CRD420251102722), we systematically searched PubMed, Cochrane Library, and Google Scholar through May 2025. Eighteen RCTs (1310 participants) involving non-diabetic adults with BMI ≥ 25 kg/m² were included. Primary outcomes were body weight and BMI; secondary outcomes included lipid profile, glycemic indices, inflammatory biomarkers, liver enzymes, and body composition. ROB 2.0 and GRADE were used to assess bias and evidence certainty.</p><p><strong>Results: </strong>L. plantarum supplementation significantly reduced body weight (MD = -1.23 kg; 95% CI: -1.97 to -0.49; p = 0.001; I² = 49%) and BMI (MD = -0.28; 95% CI: -0.54 to -0.02; p = 0.03; I² = 77%). Subgroup analysis suggested these reductions were more pronounced with multi-strain formulations than single-strain L. plantarum; however, tests for subgroup interaction were non-significant, indicating insufficient evidence to confirm a true difference in effect by formulation type. Improvements were also noted in waist circumference (MD = -1.36 cm; p = 0.003) and liver enzymes. High-certainty evidence supported body weight reduction; moderate-certainty evidence supported reductions in BMI, waist circumference, fat mass, and liver enzymes; low-certainty evidence was found for lipid, glycemic, and inflammatory outcomes.</p><p><strong>Conclusions: </strong>L. plantarum, particularly in multi-strain formulations, may provide modest yet clinically meaningful benefits in obesity management. Standardized, long-term trials are warranted. REGISTRY AND REGISTRY NUMBER FOR SYSTEMATIC REVIEWS OR META-ANALYSES: The systematic review and meta-analysis were registered on PROSPERO under the ID: CRD420251102722.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024837","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":"Clinical obesity phenotypes among older adults: prevalence, determinants, and morbidity burden from the Longitudinal Ageing Study in India.","authors":"Saurav Basu, Shubhanjali Roy","doi":"10.1038/s41366-026-02226-9","DOIUrl":"https://doi.org/10.1038/s41366-026-02226-9","url":null,"abstract":"<p><strong>Background: </strong>Routine obesity diagnosis in India largely relies on BMI, often failing to capture metabolic heterogeneity in older adults. This study is the first to operationalize the 2025 Lancet consensus framework at a national scale, distinguishing between excess adiposity (pre-clinical) and adiposity with comorbidities (clinical obesity).</p><p><strong>Methods: </strong>We analyzed data from 60640 adults aged ≥45 years from the Longitudinal Ageing Study in India (LASI, Wave 1). Using Asian-specific BMI and waist circumference thresholds integrated with physician-diagnosed conditions, participants were classified as without obesity, preclinical obesity, or clinical obesity. Multivariable regression models examined sociodemographic, behavioral, and psychosocial determinants.</p><p><strong>Results: </strong>Overall, 37.53% of older adults had either preclinical or clinical obesity, comprising 15.00% with preclinical obesity (95% CI: 14.27-15.75) and 22.53% with clinical obesity (95% CI: 21.71-23.37). Non-obesity accounted for 62.47% (95% CI: 61.55-63.39). In the fully adjusted model, higher odds of increasing obesity category were observed among women (AOR = 1.97), urban residents (AOR = 1.88), individuals in the richest MPCE quintile (AOR = 1.91), and socially isolated individuals (AOR = 1.44). Adults aged ≥70 years had lower odds (AOR = 0.80). Compared with individuals without obesity, those with preclinical or clinical obesity had higher prevalence of hypertension, diabetes, chronic heart disease, chronic bone or joint disease, high cholesterol, and multimorbidity.</p><p><strong>Conclusion: </strong>A substantial proportion of older adults in India had preclinical or clinical obesity, particularly women, urban residents, socioeconomically advantaged groups, and socially isolated individuals. Phenotype-based classification adds value beyond BMI by distinguishing excess adiposity without morbidity from adiposity with clinical manifestations, supporting refined population-level risk stratification. Public health strategies should strengthen early identification, integrate waist circumference and morbidity assessment into older-adult NCD screening, and address social and structural factors associated with obesity burden.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024850","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}