International Journal of Obesity最新文献

{"title":"Does a heritable common latent factor explain body mass index, percent body fat, and waist circumference across childhood?","authors":"Eva M. Bartsch, Sierra Clifford, Mary C. Davis, Leah D. Doane, Kathryn Lemery-Chalfant","doi":"10.1038/s41366-025-01864-9","DOIUrl":"10.1038/s41366-025-01864-9","url":null,"abstract":"Empirical data consistently suggest high heritability estimates for adiposity, with heritability peaking during childhood. However, no study has considered the potentially shared genetic and environmental etiologies of the three most commonly used adiposity metrics — body mass index (BMI), waist circumference, and percent body fat. We examined the genetic and environmental contributions to BMI, percent body fat, and waist circumference, and the extent to which their genetic and environmental variances overlap during middle childhood. We examined the genetic and environmental contributions to BMI, percent body fat, and waist circumference in a community sample of twin children (N = 254–326 pairs; female=47.8–49.9%; Non-Hispanic White=51.9–59.5%, Hispanic=29.5–35.7%) studied at ages 8, 9, 10, and 11 years by comparing the fit of two models: the independent and common pathway models. The common pathway model yielded the most parsimonious fit, indicating that covariance between indicators was best represented by a single highly heritable common latent factor. This common factor explained 97-98% of the variance in BMI regardless of age, whereas indicator-specific genetic and environmental influences explained 10–17% of the variance in percent body fat and 14–29% of the variance in waist circumference. Our findings support a highly heritable common adiposity factor for BMI, body fat, and waist circumference in a community sample of youth, and suggest that BMI is a useful measure of adiposity in large-scale epidemiological studies with limited resources in middle childhood. When resources permit, including other adiposity indicators such as percent body fat and waist circumference can provide more precise assessments for specific subgroups. Our study highlights the need for individualized approaches to managing childhood adiposity, recognizing the strong genetic component and the variability in how children respond to their environments. Theories of the etiology of childhood obesity should accommodate genetic influences to optimize prevention and intervention efforts.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 10","pages":"2051-2061"},"PeriodicalIF":3.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855167","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":"“Just put in a little more effort”: the help-seeking experience of patients living with obesity","authors":"Lucas Schreurs, Carla De Smedt, Ellen Goris, David Unuane, Martijn Schoneveld, Nele Steenackers, Sofia Pazmiño, Inge Gies, Bart Van der Schueren, Diederik De Cock","doi":"10.1038/s41366-025-01867-6","DOIUrl":"10.1038/s41366-025-01867-6","url":null,"abstract":"Early detection of the disease obesity and support for patients living with obesity could improve the success of obesity treatment and management. The factors influencing the delay in obesity treatment, defined as the period between obesity onset and treatment start, are largely unknown. The aim of our study is to explore the help-seeking behavior of PwO towards obesity treatment. In this cross-sectional qualitative study, consecutive patients visiting the obesity clinic of the University Hospitals of Brussels between December 2023 and April 2024 were invited to participate. PwO were interviewed, and data were transcribed and analysed using thematic analysis. A total of 18 PwO (61% female, median age 37 years, (IQR: 23.5–57.5)) were interviewed. The journey of PwO towards obesity care seemed complex with multiple HCPs involved. Four themes were identified as triggers for seeking obesity care: Referral from primary care, family, friends and schools; Health complications; Financial burden of living with obesity; and Increased internal motivation. Three themes were identified as factors increasing treatment delay: Inefficient referral; Pressure from society to try lifestyle approaches first; and Challenges to overcome barriers for metabolic surgery. Inefficient referral from dietitians to multidisciplinary obesity treatment was identified as the main cause of treatment delay. PwO feel discouraged by the limited effectiveness of dietary guidance, leading to disengagement from the healthcare system. Our findings identify several key barriers contributing to treatment delays for patients with obesity. People living with obesity emphasized the need for an obesity care pathway and improved communication among primary care providers, allied health professionals, and collaborating centres for obesity management (COMs) to reduce the time required to access appropriate obesity treatment. Additionally, societal perceptions framing obesity as a result of a lack of willpower were reported by patients with obesity as a barrier to seeking care.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 10","pages":"2062-2069"},"PeriodicalIF":3.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855166","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":"Gastrointestinal adverse events associated with GLP-1 RA in non-diabetic patients with overweight or obesity: a systematic review and network meta-analysis","authors":"Abdulrahman Ismaiel, Giuseppe Guido Maria Scarlata, Irina Boitos, Daniel-Corneliu Leucuta, Stefan-Lucian Popa, Nahlah Al Srouji, Ludovico Abenavoli, Dan L. Dumitrascu","doi":"10.1038/s41366-025-01859-6","DOIUrl":"10.1038/s41366-025-01859-6","url":null,"abstract":"Overweight and obesity are major global health issues, increasing disease risk and straining healthcare systems. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective for weight loss but cause gastrointestinal side effects, affecting adherence. Research often focuses on diabetics, leaving a gap in understanding their effects on non-diabetic individuals with overweight or obesity. This systematic review and dose-response network meta-analysis addresses this gap, analyzing gastrointestinal adverse events from GLP-1 RAs in non-diabetic subjects with overweight or obesity. We evaluated available evidence by searching PubMed and EMBASE databases, according to specific inclusion and exclusion eligibility criteria to evaluate gastrointestinal adverse events associated with GLP-1 RAs in non-diabetic individuals with overweight or obesity. Quality assessment of included studies was conducted using Cochrane Collaboration’s tool. Thirty-nine articles were included in the review showing a total number of 33,354 individuals. Nausea, vomiting, diarrhea, and constipation were the most common gastrointestinal adverse effects. All evaluated GLP-1 RAs led to a significant increase in nausea risk, with orforglipron showing the highest risk, followed by exenatide, tirzepatide, semaglutide, and liraglutide. Additionally, liraglutide, orforglipron, semaglutide, and tirzepatide were associated with increased vomiting risk, while cagrilinitide and exenatide showed no significant increase. Exenatide, cagrilinitide, orforglipron were not associated with diarrhea risk. Finally, semaglutide and liraglutide were associated to increased constipation risk, while cagrilinitide and exenatide showed no significant increase. GLP-1 RAs showed several adverse gastrointestinal effects in non-diabetic patients with overweight or obesity. Understanding the different risk profiles of GLP-1 RAs helps clinicians make informed treatment decisions by balancing therapeutic benefits with potential side effects.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 10","pages":"1946-1957"},"PeriodicalIF":3.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01859-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144846561","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":"Interleukin-33 promotes lipolysis of adipocytes and protects male mice against obesity via activation of β-adrenergic receptor signaling.","authors":"Qianjiang Chen, Ke Ding, Mengfan Li, Rui Ma, Jian Lin, Jialin Guan, Jingli Lu","doi":"10.1038/s41366-025-01873-8","DOIUrl":"https://doi.org/10.1038/s41366-025-01873-8","url":null,"abstract":"<p><strong>Background: </strong>Targeting intracellular lipolysis represents a therapeutic potential for treating metabolic disorders such as obesity. Interleukin (IL)-33 has been shown to exert anti-obesity effects by reducing inflammation and restricting adipocyte hypertrophy.</p><p><strong>Methods: </strong>In this study, male mice on a high-fat diet (HFD) were treated with IL-33 once every 2 days for 2 weeks. 3T3-L1 cells were treated with IL-33 to verify the down-stream effect of β1-AR activation on the adipose cells.</p><p><strong>Results: </strong>IL-33 treatment led to a reduction in adipose tissue mass and a decreased in lipid deposition in male mice with obesity, accompanied by activation of β-adrenergic receptor (β-AR) signals. Immunostaining for tyrosine hydroxylase (TH) revealed an increase of TH within the adipose tissue in male mice. Metabolomic analysis showed that IL-33 induced a distinct metabolic profile in differentiated adipocytes, with significant changes in metabolites related to lipolysis pathways. Supplementation with β1-AR inhibitor significantly inhibited IL-33-induced p-HSL and p-PKA activation. Compared to IL-33 alone, β1-AR inhibitor reduced glycerol release and increased accumulation of lipid droplets. We also illustrated the fatty acids (FAs) process by tracking FA trafficking, and found that the labeled FA localized lipid droplets (LDs) in mature adipocytes but shifted from LDs to mitochondria at 20 ng/mL IL-33.</p><p><strong>Conclusion: </strong>We summarized that IL-33 regulated mature adipocyte metabolism and enhanced lipolysis in male mice via activation of the β-AR/cAMP/PKA/HSL signaling pathway. However, given that sex is a significant determinant in obesity, future studies should investigate potential sex-specific effects of IL-33 in metabolic regulation.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835026","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":"Evidence of ethnic variations in the relationships between routinely recorded clinical factors and T2D: a systematic review and meta-analysis","authors":"Binur Orazumbekova,&nbsp;Tooba Hamdani,&nbsp;Sam Hodgson,&nbsp;Miriam Samuel,&nbsp;Daniel Stow,&nbsp;Marie Spreckley,&nbsp;Sarah Finer,&nbsp;Moneeza K. Siddiqui,&nbsp;Rohini Mathur","doi":"10.1038/s41366-025-01848-9","DOIUrl":"10.1038/s41366-025-01848-9","url":null,"abstract":"Evidence on ethnic differences in factors associated with type 2 diabetes (T2D) is mixed. We aimed to systematically review evidence on ethnic variations in the relationships between routinely recorded demographic and clinical factors and T2D. We searched Medline Complete and Embase for observational studies published between 1990 and 2023 investigating ethnic differences in factors routinely recorded in clinical encounters associated with T2D. We used random and fixed-effects meta-analysis to quantitatively summarise effect sizes across studies where possible. Risk of bias and study quality were assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute tool. PROSPERO registration: CRD42023394148. Searches identified 10,694 studies, of which, 54 (n = 10 332,949 individuals) were eligible for inclusion, including 12 suitable for meta-analysis. Included studies reported ethnic differences in age at T2D diagnosis, anthropometric measures, and factors associated with women’s health. Compared to individuals of White ethnicity, people of diverse ethnic backgrounds had 2-4-fold higher incidence and prevalence of T2D and younger age of onset. Waist-to-hip ratio (WHR) was a better discriminator of T2D across all ethnic groups compared to body mass index (BMI). While the association between overweight/obese BMI and T2D was strongest for people of White ethnicity (OR 4.85 CI 3.53–6.68) followed by Black (OR 3.27 CI 2.48–4.30) and East Asian ethnicities (OR 3.06 CI 2.29–4.16), the association between WHR and T2D was strongest for people of Black (OR 2.74, CI 2.22–3.39) than for White ethnicities (OR 2.51, CI 2.30–2.74). Included studies highlighted the emerging importance of women-health-associated factors such as index of parity, birth weight and breastfeeding, especially among women of diverse ethnicities. Ratio measures of central adiposity may better identify T2D in ethnically diverse populations than measures of overall adiposity. Sex-specific factors must be considered when assessing T2D risk. Wellcome Trust Grant 218584/Z/19/Z.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 10","pages":"1929-1945"},"PeriodicalIF":3.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01848-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821425","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":"Glycemic variability and entero-pancreatic hormones signatures after different bariatric surgery procedures: a cross-sectional study","authors":"Carolina B. Lobato,&nbsp;Sofia S. Pereira,&nbsp;Marta Guimarães,&nbsp;Bruno Soares,&nbsp;Bolette Hartmann,&nbsp;Mário Nora,&nbsp;Jens J. Holst,&nbsp;Mariana P. Monteiro","doi":"10.1038/s41366-025-01865-8","DOIUrl":"10.1038/s41366-025-01865-8","url":null,"abstract":"Bariatric surgery changes food handling and entero-pancreatic endocrine dynamics. We aimed at understanding the influence of anatomical reorganization of the gastrointestinal tract induced by metabolic and bariatric surgery (BS) on glycemic variability and the extent to which glycemic variability reflects the underlying entero-pancreatic hormone dynamics. We performed a cross-sectional study on glycemic variability after four different BS procedures in comparison with non-operated matched controls (n = 8). The surgical groups were the classic Roux-en-Y gastric bypass (C-RYGB, n = 8), a modified long biliopancreatic limb RYGB (M-RYGB, n = 7), a single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S, n = 8) and a biliopancreatic diversion with duodenal switch (BPD-DS, n = 7). Participants completed 14 days of intermittently scanned continuous glucose monitoring (isCGM). The surgical groups also underwent a mixed-meal test with hormone profiling. Our primary outcome was the mean absolute glucose change (MAG change) in the operated vs non-operated individuals. Additionally, we developed, validated and herein release an automated tool, Gluc4all, for personalized and automated continuous glucose monitoring data analysis, particularly relevant when evaluating the glycemic profile of individuals without diabetes. All surgical interventions were associated with an increase in the magnitude of postprandial glucose excursions, in anatomy-specific patterns (MAG change was 2.0-fold higher after C-RYGB and M-RYGB and 1.6-fold higher after SADI-S and BPD-DS than in non-operated controls). These isCGM findings matched the postprandial glucose, glucose-dependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1) and insulin profiles documented in the meal test. Overall, we show that BS interventions are associated with higher glycemic variability. Moreover, depending on the type of gastrointestinal anatomical reconstruction, BS yields procedure specific glycemic variability patterns. This might be due to faster glucose absorption, impaired amino acid absorption, and/or altered entero-pancreatic hormone profiles, including GLP-1 and insulin secretion.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 10","pages":"2042-2050"},"PeriodicalIF":3.8,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01865-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812055","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":"Pear-shaped body types linked to lower risk of gout: genetic evidence from Mendelian randomization.","authors":"Yu Qiu, Cantao Li, Ying Hua, Yan Huang, Lu Zhang, Jiaman Xu, Junna Zheng, Zhiling Fu, Xiaoxi Zhang, Fenfen Li, Daozong Xia","doi":"10.1038/s41366-025-01875-6","DOIUrl":"10.1038/s41366-025-01875-6","url":null,"abstract":"<p><strong>Background: </strong>Growing evidence has indicated an association between obesity, measured by body mass index (BMI), and urate levels, as well as the risk of gout. However, BMI inadequately reflects the body's fat distribution, including variations in gluteofemoral, abdominal subcutaneous, and visceral adipose tissue (GFAT, ASAT, and VAT). This study aimed to utilize Mendelian randomization (MR) to investigate the causal associations between genetically predicted fat distribution, urate levels, and the risk of gout.</p><p><strong>Methods: </strong>We performed a comprehensive investigation of nine fat distribution traits, including raw and adjusted measures of GFAT, ASAT, VAT, and their corresponding ratios, as potential exposures. Using two-sample MR analysis, we investigated the causal associations between these fat distribution traits, urate levels, and gout risk. Additionally, we conducted multivariate MR analysis to assess whether the interaction between different fat depots influenced causal effects. Furthermore, we applied a two-step MR analysis to assess their mediating effects on gout risk through urate levels. We also conducted multiple sensitivity analyses to confirm the robustness and validity of our results.</p><p><strong>Results: </strong>The MR analysis revealed a significant negative causal association between GFAT (both raw and adjusted) and urate levels as well as gout risk. Conversely, a significant positive causal association was observed between ASAT and urate levels. The mediation analysis revealed that 36% and 40% of the protective effect of raw and adjusted GFAT on the risk of gout was mediated by urate level, respectively. These findings remained consistent across multivariable analyses.</p><p><strong>Conclusions: </strong>This study provides preliminary evidence supporting the association between fat distribution, urate levels, and gout risk, suggesting a potential lower risk of gout in individuals with a pear-shaped body.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799056","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":"Association of exposure to famine early in life with indicators of obesity in adulthood: testosterone as a potential mediator?","authors":"Qingqing Cao, Zexin Jia, Changsheng Huan, Qian Gao, Pengcheng Yuan, Xin Li, Zhen Ma, Zhenxing Mao, Chongjian Wang, Wenqian Huo","doi":"10.1038/s41366-025-01876-5","DOIUrl":"https://doi.org/10.1038/s41366-025-01876-5","url":null,"abstract":"<p><strong>Background: </strong>The Chinese famine occurred between 1959 and 1961. Findings on early exposure to famine on obesity have been inconsistent. Therefore, this study aimed to assess the effect of early exposure to famine on obesity and the mediating role of testosterone.</p><p><strong>Methods: </strong>The design enrolled 2667 participants from the Henan Rural Cohort Study. The associations between early famine exposure and indicators of obesity and obesity were explored using generalized linear models and logistic regression models, respectively. Stratified analyses by sex were performed to account for potential sex-specific effects. Mediation analyses were applied to address the contribution of testosterone in mediating the impact of early-life famines on obesity and its indicators.</p><p><strong>Results: </strong>The median age of the study participants was 54 (range: 48-64) years old. Fetal famine exposure was positively associated with central obesity (waist circumference (WC) and waist-to-hip ratio (WHR)) in both sexes. Nevertheless, childhood famine exposure (3-9 years old after 3-year famine) was negatively associated with general obesity (body mass index (BMI)), and central obesity (WC) in males. In contrast, childhood famine exposure in females was positively associated with central obesity (WHR and waist-to-height ratio (WHtR)). Mediation analyses suggested that testosterone partially mediated the association of childhood famine exposure with central obesity (WC), BMI, WC, and WHtR in males, with mediation effect proportions ranging from 3.27% to 11.85%. In females, testosterone mediates the role of childhood famine in increasing the risk of central obesity (WHR), WHR, and WHtR, with mediating effect proportions of 5.50%, 3.60%, and 7.17%, respectively.</p><p><strong>Conclusion: </strong>Fetal famine exposure increases the risk of central obesity. Childhood famine exposure showed sex-specific effects on central obesity, with a negative association in males and a positive association in females. Additionally, testosterone has been found for the first time to partially mediate the positive association of childhood famine on obesity.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799055","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":"Long-term prognostic value of myocardial work analysis across obesity stages: insights from a community-based study","authors":"Fjolla Zhubi Bakija,&nbsp;Máté Tolvaj,&nbsp;Ádám Szijártó,&nbsp;Márton Tokodi,&nbsp;Andrea Ferencz,&nbsp;Bálint Károly Lakatos,&nbsp;Zsuzsanna Ladányi,&nbsp;Loretta Kiss,&nbsp;Zsolt Szelid,&nbsp;Pál Soós,&nbsp;Béla Merkely,&nbsp;Zsolt Bagyura,&nbsp;Attila Kovács,&nbsp;Alexandra Fábián","doi":"10.1038/s41366-025-01863-w","DOIUrl":"10.1038/s41366-025-01863-w","url":null,"abstract":"Obesity and overweight are major contributors to cardiovascular disease and adverse outcomes, yet subclinical systolic dysfunction in low-risk individuals often remains undetected by conventional echocardiographic metrics. Myocardial work (MW) analysis offers a more sensitive assessment of left ventricular (LV) function. Thus, we aimed to assess the prognostic value of MW indices in a low-risk, community-based cohort with different stages of obesity. We retrospectively identified 1330 volunteers from the Budakalász population-based screening program stratified into 3 groups: patients with normal weight, overweight, and obesity based on BMI. All underwent 2D echocardiography to measure LV ejection fraction (EF), LV global longitudinal strain (GLS), global MW index (GWI), global wasted work (GWW), and global MW efficiency (GWE). The primary endpoint was all-cause mortality over a median follow-up of 11 years. During follow-up, 138 (10.4%) participants died. LVEF was not predictive of outcome. By univariable Cox regression analysis, GWI was a predictor of outcomes, alongside GWW, GWE, and GLS in the total cohort. In normal weight group, only GLS was a predictor. In the group with overweight, GLS, GWE (HR 0.917 [95%CI 0.874–0.963], p &lt; 0.00) and GWW (HR 1.341 [95%CI 1.121–1.604], p = 0.001) were predictors of mortality. Among patients with obesity, GWI was the only significant predictor (HR 0.929 [95%CI 0.875–0.986], p = 0.015). In patients with overweight and obesity with GWI values below the standard cut-off of 1292 mmHg%, the risk of all-cause mortality was more than 2 times higher. Myocardial work metrics were significant predictors of long-term outcomes in low-risk individuals with different stages of obesity. Our findings highlight that conventional echocardiographic metrics may underestimate cardiovascular risk in patients with overweight and obesity.","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":"49 10","pages":"2032-2041"},"PeriodicalIF":3.8,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41366-025-01863-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794393","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":"Implicit and explicit weight bias among healthcare professionals.","authors":"Jane W Liang, Christie Buonpane, Shengxuan Wang, Arghavan Salles","doi":"10.1038/s41366-025-01878-3","DOIUrl":"https://doi.org/10.1038/s41366-025-01878-3","url":null,"abstract":"<p><p>Patients with overweight and obesity are negatively impacted by weight bias in healthcare, leading to poor quality of care and poor health outcomes. Implicit bias can be estimated from reaction times during Implicit Association Tests (IATs), and explicit bias can be self-reported. Data from over one million online survey responses collected by Project Implicit between 2006-2022 suggest that implicit and explicit weight bias persist among diagnosing and treating practitioners, other healthcare workers, and non-healthcare workers. Moreover, our findings indicate that diagnosing and treating workers could express more explicit bias than others. Across all three occupation groups examined, it appears that men have more explicit negative attitudes toward people with obesity, and explicit weight bias appears to be decreasing over time. Given the powerful impact healthcare workers have on the experiences of patients, more efforts should be made to educate them on how to recognize their weight biases, the negative impact of those biases, and how to take appropriate action.</p>","PeriodicalId":14183,"journal":{"name":"International Journal of Obesity","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789078","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}