International Journal of Obesity最新文献

{"title":"Incidence and risk factors of post-metabolic and bariatric surgery hypoglycemia: a systematic review.","authors":"Huaijun Zheng, Lize Sun, Linjie Wang, Yuxing Zhao, Fengying Gong, Huijuan Zhu","doi":"10.1038/s41366-024-01651-y","DOIUrl":"https://doi.org/10.1038/s41366-024-01651-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to systematically review the existing literature to summarize the incidence and risk factors of post-metabolic and bariatric surgery hypoglycemia (MBSH).</p><p><strong>Methods: </strong>We searched PubMed, Medline, Embase, and the Cochrane Library databases for the studies published from inception to August 2023. Randomized controlled trials and analytical studies that investigated the incidence or risk factors of MBSH after different surgery techniques (including Roux-en-Y gastric bypass, sleeve gastrectomy, gastric banding, duodenal switch, omega-loop gastric bypass, and vertical banded gastroplasty) were involved. The incidence and risk factors of MBSH were extracted and described separately based on different diagnostic criteria and then summarized the risk factors and their statistical findings collectively.</p><p><strong>Results: </strong>Twenty-nine studies were reviewed with follow-up ranging from 1 to 22 years. The incidence of MBSH ranged significantly across different diagnostic methods: 2.6-66.4% (self-report), 6.6-61.8% (oral glucose tolerance test), 29.4-78.6% (mixed-meal tolerance test), and 50-75% (continuous glucose monitoring). Patients with a mean age of 49.8 years and 89.0% of them were women with a better glycemic control who undergo RYGB and achieve 86.5% of estimated weight loss from surgery should be particularly vigilant about the possibility of developing MBSH. Distinct biomarkers such as IGF-1 (OR 1.06), fasting glicentin (AUC 0.81), HbA1c (AUC 0.76), and absolute weight reduction (AUC 0.72), greater fluctuations in glucose (OR 1.98) are valuable in promptly detecting MBSH. Specifically, patients with prior cholecystectomy or antidepressant therapy should be particularly cautious.</p><p><strong>Conclusion: </strong>The review highlights higher MBSH risk in younger women with significant weight loss after RYGB, and those with prior cholecystectomy or antidepressant use. Systematic summarization of MBSH criteria allowed us to identify the predictors for MBSH, which can aid in early diagnosis and treatment, reducing the need for prolonged monitoring.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500445","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":"Drugs used in psychiatry causing an increase in body weight in children-a review.","authors":"Karolina Kuźbicka, Iga Pawłowska, Ivan Kocić","doi":"10.1038/s41366-024-01662-9","DOIUrl":"https://doi.org/10.1038/s41366-024-01662-9","url":null,"abstract":"<p><p>Body weight gain is a prevalent adverse effect observed in psychiatric medication therapy. With the notable increase in mental health diagnoses among children and adolescents over the last decade, exacerbated by the COVID-19 pandemic, the use of medications associated with weight gain poses an additional risk for obesity development. This study aimed to identify psychiatric drugs that may induce weight gain in children as a side effect. Twenty-nine publications were included in this systematic review, investigating the effects of nineteen different drugs on children's weight. The majority of these drugs belonged to atypical antipsychotics and anticonvulsants. Nearly all included articles reported that the examined substances resulted in weight gain in children. As childhood obesity has become a significant problem with various metabolic, psychological and social consequences, it is crucial to carefully consider therapy options. In addition to evaluating effectiveness, it is important to also assess the potential for weight gain. Clinicians and nutrition specialists should individually evaluate patients' nutritional needs, evaluate obesity risk, and provide appropriate dietary guidance to minimalize the risk of weight gain.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500444","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":"What internet- and mobile-based interventions are currently available for adults with overweight or obesity experiencing symptoms of depression? A systematic review.","authors":"Katja Schladitz, Alina Seibel, Melanie Luppa, Steffi G Riedel-Heller, Margrit Löbner","doi":"10.1038/s41366-024-01654-9","DOIUrl":"https://doi.org/10.1038/s41366-024-01654-9","url":null,"abstract":"<p><p>Given the high prevalence of overweight and obesity and high comorbidity of depressive symptoms, there is a need for low-threshold, accessible care approaches for people with overweight/obesity aimed at improving mental health. Internet and mobile-based interventions (IMI) represent an innovative complementary treatment option. This review systematically searches for IMI aimed at improving mental health in people with overweight/obesity. We conducted a systematic literature search according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria in the databases MEDLINE, Cochrane Library, PsycINFO, Web of Science and Google Scholar. Randomized controlled trials (RCTs) of IMI for adults with overweight/obesity and comorbid depressive symptoms aiming at improving mental health were screened and extracted. Study quality was assessed with RoB 2 (revised Cochrane Risk of Bias tool in RCTs). After excluding duplicates, n = 790 results were included in title and abstract screening. After full-text-screening of n = 26 studies, n = 3 RCT studies were included. All interventions aimed to reduce both weight and depressive symptoms. In two RCTs, a significant reduction in both depressive symptoms and weight was achieved. One RCT indicated a significant reduction in depressive symptoms, but not in weight. Two intervention had a duration of 6 months and were guided by health carers, the third takes 3 months and can be used without professional guidance. There is evidence that IMI are effective in improving mental health for people with overweight/obesity and comorbid depressive symptoms. However, currently there are few interventions aiming at reducing depressive symptoms, all targeting English-speaking people. As IMI for depressive symptoms can be easily integrated in the somatic therapy of obesity as additional option and has high public health potential, target group-adapted and low-threshold accessible interventions in different languages should be developed and implemented for improving mental health in people with overweight/obesity. Prospero registration number: CRD42023361771.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465408","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":"Associations of body composition measures with circulating insulin-like growth factor-I, testosterone, and sex hormone-binding globulin concentrations in 16,000 men","authors":"Matthew C. Hynes,&nbsp;Cody Z. Watling,&nbsp;Yashvee Dunneram,&nbsp;Timothy J. Key,&nbsp;Aurora Perez-Cornago","doi":"10.1038/s41366-024-01633-0","DOIUrl":"10.1038/s41366-024-01633-0","url":null,"abstract":"Adiposity is positively associated with risk of some cancer sites and other health conditions in men; however, it is unclear if endogenous hormones play a role in these associations. We examined how body composition, measured from magnetic resonance imaging (MRI) and common measures of adiposity (e.g., body mass index (BMI)), are related to hormone concentrations in men from the UK Biobank study. Up to 16,237 men with available body composition data (including visceral, subcutaneous, and liver fat, muscle fat infiltration (MFI), lean tissue, and common adiposity measures) and serum hormone measurements (insulin-like growth factor-I (IGF-I), total testosterone, sex hormone-binding globulin (SHBG), and calculated free testosterone) were included. Multivariable-adjusted linear regression models were used to determine the geometric mean hormone and SHBG concentrations across categories of each exposure. Common measurements of adiposity were highly correlated with MRI measures of central and total adiposity (r = 0.76–0.91), although correlations with ectopic fat (liver fat and MFI) were lower (r = 0.43–0.54). Most adiposity measurements showed an inverse U- or J-shaped association with circulating IGF-I and free testosterone; however, MFI was linearly inversely associated, and lean tissue volume was positively associated with both IGF-I and free testosterone concentrations. All body composition measures were inversely associated with total testosterone and SHBG concentrations (relative geometric mean difference between Q5 vs. Q1: 20–30%). Our results show that common adiposity and most MRI measures of adiposity relate similarly to serum hormone concentrations; however, associations with ectopic fat (particularly MFI) and lean tissue were different.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"48 12","pages":"1809-1817"},"PeriodicalIF":4.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41366-024-01633-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465398","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":"Epigenetic programming of obesity in early life through modulation of the kynurenine pathway.","authors":"Mojgan Gharipour, Jeffrey M Craig, Garth Stephenson","doi":"10.1038/s41366-024-01647-8","DOIUrl":"https://doi.org/10.1038/s41366-024-01647-8","url":null,"abstract":"<p><p>Childhood obesity is a global health concern that has its origins before birth. Although genetics plays a crucial role, increasing evidence suggests that epigenetic modifications during fetal life could also influence its incidence. In this model, during the fetal period, interactions between genetic makeup, intrauterine factors, and environmental conditions, increase the risk of childhood obesity. This is in accordance with the Developmental Origins of Health and Disease (DOHaD) hypothesis, in which specific intrauterine environments can have long-lasting effects on the immune system's essential functions during crucial stages of fetal growth, resulting in permanent changes to the immune function of the offspring. Consequently, dysfunction can consequently make the offspring more prone to inflammatory and immune-related disorders later in life. In this review, we examine how maternal inflammation could influence the risk of childhood obesity. We propose that during pregnancy, modification of the expression of critical genes in metabolic and signaling pathways, such as the kynurenine (Kyn) pathway, occurs due to increased levels of maternal inflammation. We also propose that such expression differences are mediated by epigenetic changes. Furthermore, we also hypothesize that the Kyn pathway produces metabolites that have immunoregulatory effects and may play a crucial role in regulating inflammation during pregnancy. As a result, interventions aimed at improving maternal inflammation may be able to help alleviate the risk of childhood obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465402","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":"Effects of various exercise types on inflammatory response in individuals with overweight and obesity: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Chaofan Chen, Dong Zhang, Mingyi Ye, Yanwei You, Yiling Song, Xiaoke Chen","doi":"10.1038/s41366-024-01649-6","DOIUrl":"https://doi.org/10.1038/s41366-024-01649-6","url":null,"abstract":"<p><strong>Objective: </strong>To explore effective exercise types for reducing chronic inflammation in individuals with overweight and obesity (IOO) while accounting for confounders.</p><p><strong>Methods: </strong>A systematic search for RCTs in English between January 2000 and August 2023 was conducted to evaluating exercise effects on inflammatory biomarkers in IOO. A network meta-analysis conducted.</p><p><strong>Results: </strong>A total of 123 RCTs were analyzed. Different exercise type yielded distinct effects on various inflammatory biomarkers. Specifically, aerobic exercise combined with resistance training (COM) and aerobic exercise (AE) were the most effective for improving leptin levels. AE exhibited the greatest effectiveness in reducing CRP and increasing adiponectin. High-intensity interval training (HIIT) was identified as the most effective exercise modality for ameliorating IL-6, TNF-α, and IL-10. Resistance training (RT) had the least effect compared to other exercise types. Meta regression and subgroup analyses revealed that high-intensity AE demonstrated a greater effect size compared to moderate-intensity AE. The impact of AE on IL-10 was positively associated with both the training period and the age of participants. Positive correlations were observed between reductions in body fat and the effect sizes of CRP, TNF-α, and IL-10. Gender influenced AE effects on IL-6 and TNF-α, with females responding better.</p><p><strong>Conclusion: </strong>This study highlights the potential of exercise in alleviating the inflammatory status in IOO, with different exercise types showing various effects on specific inflammatory biomarkers. The intensity and duration of exercise had a dose-response relationship with intervention effectiveness. Changes in body composition correlated with the effectiveness of the intervention. COM, AE, and HIIT are recommended exercise approaches.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465401","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":"Role of Planetary Health Diet in the association between genetic susceptibility to obesity and anthropometric measures in adults.","authors":"Tiina Suikki, Mirkka Maukonen, Heidi Marjonen-Lindblad, Niina Erika Kaartinen, Tommi Härkänen, Pekka Jousilahti, Anne-Maria Pajari, Satu Männistö","doi":"10.1038/s41366-024-01656-7","DOIUrl":"https://doi.org/10.1038/s41366-024-01656-7","url":null,"abstract":"<p><strong>Background/objective: </strong>The roles of overall diet quality in linking genetic background with anthropometric measures are unclear, particularly regarding the recently developed Planetary Health Diet (PHD). This study aims to determine if the PHD mediates or moderates the relationship between genetic susceptibility to obesity and anthropometric measures.</p><p><strong>Subjects/methods: </strong>The study involved 2942 individuals from a Finnish population-based cohort (54% women, mean age 53 (SD ± 13) years). Habitual diet was assessed using a validated 130-item food frequency questionnaire, and the PHD Score (total score range 0-13 points) was adapted for Finnish food culture to evaluate diet quality. Genetic susceptibility to obesity was evaluated with a polygenic risk score (PRS) based on one million single nucleotide polymorphisms associated with body mass index (BMI). Baseline anthropometrics included weight, height, waist circumference (WC), and body fat percentage, with changes in these measures tracked over 7 years. A five-step multiple linear regression model and multivariable logistic regression with interaction terms were used to assess the mediating and moderating effects of the PHD. These analyses were also replicated in another Finnish cohort study (2 834 participants).</p><p><strong>Results: </strong>PRS for BMI was positively associated with baseline BMI and changes in anthropometric measures, except waist circumference (p = 0.12). Significant associations were observed for baseline BMI and WC (p < 0.001), changes in BMI and WC (p = 0.01), and body fat percentage change (p = 0.05). However, the PHD (average score 3.8 points) did not mediate or moderate these relationships. These findings were consistent in the replication cohort.</p><p><strong>Conclusion: </strong>Diet quality assessed with the PHD did not mediate or moderate the associations between genetic susceptibility to obesity and anthropometric measures. This lack of effect may be partly due to low adherence to the PHD and the older age of participants ( > 50 years) at baseline.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465405","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 relationship between leptin-to-adiponectin ratio and HOMA-IR and metabolic syndrome in five African-origin populations.","authors":"Nadia Sweis, Julianne Jorgensen, Julia Zeng, Candice Choo-Kang, Joseph Zapater, Kweku Bedu-Addo, Terrence Forrester, Pascal Bovet, Estelle V Lambert, Walter Riesen, Wolfgang Korte, Yang Dai, Lara R Dugas, Brian T Layden, Amy Luke","doi":"10.1038/s41366-024-01655-8","DOIUrl":"10.1038/s41366-024-01655-8","url":null,"abstract":"<p><strong>Objective: </strong>This cross-sectional study aims to assess the associations between serum leptin, adiponectin, leptin-to-adiponectin ratio (L/A ratio), and metabolic syndrome (MS) and HOMA-IR in five African-origin populations: Ghana, South Africa, Jamaica, Seychelles, and US.</p><p><strong>Methods: </strong>Clinical measures included serum glucose, insulin, adipokines, blood pressure and anthropometric measures. MS was determined using the Harmonized criteria. The final sample included 2087 adults.</p><p><strong>Results: </strong>After adjusting for age, sex, and fat mass, L/A ratio, unlike HOMA-IR, was significantly associated with MS across all sites (p < 0.001). Within sites, L/A ratio was only associated with MS and HOMA-IR in the US (p < 0.001) and South Africa (p < 0.01), respectively. Leptin was associated with MS in South Africa only (p < 0.05) but was significantly associated with HOMA-IR across all five sites and within the US (p < 0.05). Similarly, adiponectin was associated with HOMA-IR in South Africa (p < 0.05) and with MS across all five sites (p < 0.001) and within each site separately, except Ghana.</p><p><strong>Conclusions: </strong>Our study suggests that individuals of the African diaspora in different geographical locations may differ in the determinants of MS. Future studies should investigate the determinants for the disparate relationships between MS, IS and adipokines across different African-origin populations.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465407","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":"Loss of body weight is dose-dependently associated with reductions in symptoms of hip osteoarthritis.","authors":"Zubeyir Salis, Ryan Gallagher, Luke Lawler, Amanda Sainsbury","doi":"10.1038/s41366-024-01653-w","DOIUrl":"https://doi.org/10.1038/s41366-024-01653-w","url":null,"abstract":"<p><strong>Background/objectives: </strong>While weight loss is recommended for managing hip osteoarthritis (OA), most evidence comes from knee OA studies, limiting its applicability to hip OA. This study addresses this gap by examining the effects of weight loss on hip OA symptoms.</p><p><strong>Design and setting: </strong>A retrospective audit of routinely collected healthcare data from participants enrolled in the Osteoarthritis Healthy Weight for Life (OAHWFL) program, designed for individuals with knee or hip OA.</p><p><strong>Participants: </strong>In total, 1714 adults with hip OA were selected from the OAHWFL program; 1408 completed the initial 18-week weight loss phase, while 306 did not complete it. After 18 weeks, participants transitioned to an indefinite weight maintenance phase.</p><p><strong>Exposure: </strong>Percentage change in body weight from baseline at 18 weeks.</p><p><strong>Outcomes: </strong>Changes in the five subscales of the Hip Disability and Osteoarthritis Outcome Score (HOOS) (Pain, Activity Limitations in Daily Living, Stiffness and Range of Motion, Sports and Recreation Function, and Hip-related Quality of Life) from baseline to 18 weeks.</p><p><strong>Statistics: </strong>Linear regression, adjusted for sex and baseline values of age, weight, and respective HOOS scores, assessed the relationship between percentage weight change (analyzed as both a continuous variable and in categories: ≤2.5%, >2.5-5.0%, >5.0-7.5%, >7.5-10%, and >10% of baseline weight) and changes in all five HOOS subscales.</p><p><strong>Results: </strong>At baseline, participants had a mean age of 65.14 years, 70% were female, and 78% were individuals with obesity (Body Mass Index ≥30 kg/m²). A statistically significant dose-response relationship was observed between weight loss and improvements in all HOOS subscales, with the greatest improvement in the Hip-related Quality of Life subscale (14.42 points, 31.14%) for >10% weight loss.</p><p><strong>Conclusion: </strong>Our findings suggest that weight loss is associated with reduced symptoms of hip OA, supporting weight loss as an effective treatment strategy for hip OA.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465404","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":"Global barriers to decision makers for prioritizing interventions for obesity.","authors":"Lars Holger Ehlers, Nicoline Weinreich Reinstrup, Renée Hangaard Olesen, Jens-Christian Holm, Phil McEwan, Carel W Le Roux","doi":"10.1038/s41366-024-01650-z","DOIUrl":"https://doi.org/10.1038/s41366-024-01650-z","url":null,"abstract":"<p><p>The treatment of obesity remains underprioritized. New pharmacologic options for the treatment of obesity have shown effectiveness and safety but are not widely reimbursed. Despite the unmet need and the existence of effective prevention and treatment strategies, substantial barriers exist to effectively address obesity as a disease. The purpose of this scoping review was to investigate the barriers for decision makers in prioritizing interventions for obesity and to seek out interconnection between barriers to prevention and treatment. A scoping review was conducted using a systematic search of both scientific databases and Health Technology Assessment (HTA) databases. Studies that addressed barriers to reimbursement or prioritization of obesity treatment and prevention were included. A total of 26 articles and 14 HTAs were included. Four main barriers for decision makers to prioritize new interventions for obesity were identified: perceptions, knowledge, economics, and politics. There was a high degree of interconnectedness among barriers, as well as large overlaps between barriers in relation to bariatric surgery, pharmacologic treatments, and prevention regulation. Multiple barriers exist that impact decision makers in prioritizing interventions for treating obesity. A strong interconnectedness of the barriers was found, indicating a systems approach to improve global prioritization to address the disease. This study suggests that decision makers should carefully consider all main barriers when addressing the obesity epidemic.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465403","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}