Obesity Science & Practice最新文献

{"title":"Mapping the Behavioral Weight Management Ecosystem in the East of England to Inform the Implementation of Electronic Signposting.","authors":"Natalie An Qi Tham, Fredrik Kjell Bodell, Helen M Parretti, Helena Jopling, Zarnie Khadjesari","doi":"10.1002/osp4.70155","DOIUrl":"10.1002/osp4.70155","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a leading cause of ill health in England and places a substantial burden on health systems and the economy. Behavioral weight management services (WMS) are central to reducing obesity-related risk, but their reach remains limited. Electronic signposting (eSignposting), which uses electronic health records and digital communication to connect patients with appropriate services, may improve access to behavioral WMS. Effective and equitable implementation of eSignposting requires a comprehensive understanding of the behavioral WMS ecosystem, including its key components and interdependencies.</p><p><strong>Objective: </strong>This study aimed to characterize the behavioral WMS ecosystem in the East of England (Norfolk, Suffolk, and North-East Essex) to identify opportunities and considerations for implementing eSignposting.</p><p><strong>Methods: </strong>A qualitative study was conducted using semi-structured interviews with professional stakeholders (<i>n</i> = 11) involved in the commissioning, referral, and delivery of behavioral WMS. Directed content analysis was used to develop ecosystem maps and a comprehensive inventory of services across the region.</p><p><strong>Results: </strong>The findings revealed a complex behavioral WMS landscape spanning the local authority, national, commercial, and voluntary sectors. Self-referral and primary care referral emerged as the predominant routes to accessing behavioral WMS. Ecosystem maps identified key entry points where eSignposting could maximize reach and impact. Analysis of inter-stakeholder relationships also highlighted potential unintended consequences of eSignposting, including increased pressure on local services, preferential uptake of digitally accessible commercial programmes, and the risk of digital exclusion among underserved populations, enabling these issues to be proactively addressed in the future design and implementation of eSignposting.</p><p><strong>Conclusion: </strong>The behavioral WMS ecosystem in East England is multifaceted and interconnected. Ecosystem mapping provides valuable insight into referral pathways and stakeholder relationships, supporting the development of effective and equitable eSignposting strategies to improve access to behavioral WMS while minimizing risks to service equity and sustainability.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 3","pages":"e70155"},"PeriodicalIF":2.5,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13238532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consistent Support Group Attendance Is Vital for Sustained Total Body Weight Loss in a Community Gastroenterology Clinic.","authors":"Sangini Tolia, Sejal Gunaratnam, Nishant Kumar, Mallory Evans, Caitlin Seibel, Aruna V Sarma, Naresh Gunaratnam","doi":"10.1002/osp4.70157","DOIUrl":"10.1002/osp4.70157","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is a major modifiable risk factor for gastrointestinal disease. Although lifestyle modification remains the basis of treatment, these interventions are often ineffective when self-directed. This study aimed to assess the effect on weight loss when lifestyle modification is paired with a support group model.</p><p><strong>Methods: </strong>Ninety-four patients with obesity enrolled in the weight loss program at a community gastroenterology practice and participated in a 6-month support group. These sessions provided patients with a space to discuss shared experiences and receive education. Total body weight loss was examined by the level of support group attendance.</p><p><strong>Results: </strong>Patients who demonstrated high levels of support group attendance (≥ 75%) had significantly greater mean absolute (<i>p</i> = 0.0004) and total percentage body weight loss (<i>p</i> < 0.0001) compared to those who attended fewer sessions and overall were significantly more likely to achieve clinically significant total body weight loss (≥ 10%) (<i>p</i> = 0.0008) over the 6-month period after adjustment for age.</p><p><strong>Conclusion: </strong>This study demonstrates that lifestyle modification is effective in achieving clinically significant weight loss when patients have consistent engagement, measured here by attendance, in a support group. Regular support group attendance has been validated as an effective tool to maintain lifestyle modification participation and adherence, and it appears equally important in sustaining long-term weight loss.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 3","pages":"e70157"},"PeriodicalIF":2.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Total Body Fat Percentiles, Obesity and Cardiometabolic Health Biomarkers in Adults in the United States.","authors":"Grant Herrington, Luyu Xie, Zhenglin Yuan, John Clark, Anna C Rivara, M Sunil Mathew, Sarah Khan, Deepali K Ernest, Jaime P Almandoz, Sarah E Messiah","doi":"10.1002/osp4.70158","DOIUrl":"10.1002/osp4.70158","url":null,"abstract":"<p><strong>Objective: </strong>To estimate total body fat percentage (TBFP) percentiles and their association with obesity and cardiometabolic risk biomarkers in the United States adult population.</p><p><strong>Methods: </strong>Cross-sectional data for adults (20-59 years) from the 2011-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed (<i>N</i> = 14,347). TBFP was assessed using dual-energy X-ray absorptiometry. TBFP percentiles were calculated using age-adjusted, weighted quantile regression. Receiver operating characteristic (ROC) analyses assessed the ability of TBFP to predict obesity (body mass index [BMI] ≥ 30 kg/m²), elevated HbA1c (≥ 5.7%), and alanine aminotransferase (ALT) thresholds (≥ 20 and ≥ 40 U/L); and the ability of BMI to predict elevated TBFP.</p><p><strong>Results: </strong>TBFP percentiles were similar across groups, but non-Hispanic Black men had significantly lower odds of TBFP ≥ 90th percentile compared with non-Hispanic White men. TBFP demonstrated accuracy in predicting BMI-defined obesity (AUC 0.83-0.91), and BMI demonstrated accuracy in predicting elevated TBFP (AUC 0.80-0.90). TBFP had limited ability to predict elevated HbA1c (AUC 0.52-0.65) and ALT (AUC 0.51-0.63).</p><p><strong>Conclusions: </strong>TBFP percentiles are associated with BMI-defined obesity but are insufficient to predict cardiometabolic risk independently. These findings support the continued use of BMI as a screening tool and suggest that TBFP may complement but not replace existing measures.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 3","pages":"e70158"},"PeriodicalIF":2.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity- and Glucose-Dependent Differential Autophagy Marker Expression in Adipose Tissues and Adipocytes.","authors":"Edita Islami, Andreas Schmid, Daniel Steger, Sebastian Köhler, Andreas Schäffler, Thomas Karrasch","doi":"10.1002/osp4.70150","DOIUrl":"10.1002/osp4.70150","url":null,"abstract":"<p><strong>Background: </strong>Autophagy is an evolutionarily highly conserved process and plays an important role in cellular homeostasis and metabolism. In obesity and obesity-associated insulin resistance, both enhanced and suppressed autophagy have been observed in adipose tissues (AT).</p><p><strong>Objective and methods: </strong>We report on a panel of 7 autophagy markers critically involved in mammalian cellular autophagy in a cohort of patients with obesity (<i>n</i> = 40; mean BMI 54.8 ± 6.7 kg/m²) versus lean individuals (<i>n</i> = 10; mean BMI = 22.7 ± 1.7 kg/m²), during 3T3-L1 adipocyte differentiation in vitro and in mature 3T3-L1 adipocytes in response to insulin stimulation under physiologic versus high-glucose conditions in vitro.</p><p><strong>Results: </strong>Autophagy markers exhibited a differential expression pattern in subcutaneous AT in patients with obesity as compared to patients with normal weight: LAMP2, ATG5, MAP1LC3B and SIRT1 were reduced in patients with obesity, while LAMP1 and SIRT6 were increased. SIRT1 was reduced in visceral versus subcutaneous AT and in patients with obesity with type 2 diabetes mellitus. ATG5 expression in subcutaneous AT correlated positively with systemic HDL cholesterol levels, and LAMP2 and MAP1LC3B expression in subcutaneous AT correlated positively with systemic pro-inflammatory Meteorin-like protein levels (METRNL). LAMP1, LAMP2, BECLIN1, ATG5 and MAP1LC3B increased during 3T3 adipocyte differentiation in vitro, while SIRT1 expression decreased. LAMP2 and MAP3LC3B increased in response to insulin stimulation in mature adipocytes under physiological glucose conditions, while LAMP2 expression increased under high-glucose conditions. Insulin stimulation reduced SIRT1 expression in mature adipocytes under high glucose conditions. Metformin treatment increased BECLIN1 and ATG5 expression in mature adipocytes.</p><p><strong>Conclusions: </strong>These observations indicate that adipocyte differentiation, glucose and insulin stimulation, pharmacological interventions and local and systemic inflammation associated with obesity differentially impact on individual autophagy markers both on a cellular and systemic level, potentially explaining the inconsistent effects in patients with obesity reported in the literature.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 3","pages":"e70150"},"PeriodicalIF":2.5,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Digital Make a Difference? Willingness-to-Pay for Digital Versus Offline Weight Loss in Germany.","authors":"Kevin Helms, Stefan K Lhachimi, Wolf Rogowski, Oliver Lange","doi":"10.1002/osp4.70151","DOIUrl":"10.1002/osp4.70151","url":null,"abstract":"<p><strong>Background: </strong>Germany introduced both digital health applications (DiGA) and an \"offline\" structured disease management program (DMP) for obesity within statutory health insurance. Given limited resources and ongoing reimbursement decisions, evidence on how individuals with obesity assessed the value of intervention delivery in terms of their willingness to pay (WTP) remained limited.</p><p><strong>Objective: </strong>This study assessed the WTP of individuals with obesity (BMI ≥ 30 kg/m²) for a DiGA and a structured \"offline\" DMP and examined whether digital interventions better aligned with their preferences than offline interventions.</p><p><strong>Methods: </strong>An online contingent valuation survey was conducted among 424 participants with a BMI ≥ 30 kg/m² in Germany. Monthly WTP under a hypothetical non-coverage scenario was analyzed in relation to participants' demographic and socioeconomic characteristics using a two-part regression model.</p><p><strong>Results: </strong>The mean WTP for the DiGA was €16.15 per month (95% CI: €14.22-€18.09) and was significantly positively associated with older age (€0.24 higher per year, <i>p</i> = 0.02) and higher digital affinity (€6.91 higher per unit, <i>p</i> = 0.01). The mean WTP for the DMP was €18.70 per month (95% CI: €16.52-€20.90) and was significantly positively associated with female sex (€6.20 higher, <i>p</i> = 0.02) and higher digital infrastructure (€2.63 higher per unit, <i>p</i> = 0.04).</p><p><strong>Conclusion: </strong>Respondents showed a positive WTP for weight loss interventions, yet at an amount far below DiGA manufacturer prices of approximately €70 per month. The small difference between digital and offline formats suggested that the perceived effectiveness of the intervention had a greater influence on WTP than the format.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 3","pages":"e70151"},"PeriodicalIF":2.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Outcomes in Telemedicine and Long-Acting Incretin-Specific Behavioral Intervention.","authors":"Leslie J Heinberg, Alexandra M Lee, Gary D Foster, Alex Zajichek, Spencer Nadolsky, Amy DiVita, Daniel Rotroff, Michelle I Cardel","doi":"10.1002/osp4.70149","DOIUrl":"10.1002/osp4.70149","url":null,"abstract":"<p><strong>Background: </strong>Newer generation anti-obesity medications such as semaglutide and tirzepatide are highly efficacious, resulting in a proliferation of telehealth prescribers. Few, however, augment medication with a behavioral intervention, and little research has examined the impact of these medications on psychosocial variables.</p><p><strong>Objective: </strong>This study evaluated the efficacy of a telehealth provision of semaglutide/tirzepatide with a virtual behavioral program on psychosocial outcomes at 12 and 24 weeks.</p><p><strong>Methods: </strong>In this single-arm pragmatic trial, 180 participants (M age = 44.1; 91% female; 81% white; M weight = 102.6 kgs) were recruited from a telemedicine obesity program (WeightWatchers Clinic) and offered an adjunctive virtual behavioral program tailored for patients on long-acting incretin therapy. Participants completed the PHQ-8 measuring depression, Perceived Stress Scale, Self-Compassion Scale, WHO-5 measuring well-being, Weight Bias Internalization Scale-2F and Impact of Weight on Quality of Life-Lite at baseline, 12 and 24 weeks. Wilcoxon signed-rank tests were conducted to evaluate outcome differences. <i>p</i> values were adjusted using a False Discovery Rate approach. Intent-to-treat analysis was performed using last observation carried forward (LOCF).</p><p><strong>Results: </strong>There were significant improvements from median baseline to 24 weeks in measures of depression (-2), perceived stress (-3), well-being (3), weight bias internalization (-0.6), and impact of weight on quality of life (-18). All <i>p</i>'s < 0.001 in the baseline to 24-week analyses with similar results shown at 12 weeks.</p><p><strong>Conclusions: </strong>Virtually delivered obesity treatment combining telemedicine and a long-acting incretin-specific behavioral program demonstrated clinically significant improvements in psychosocial outcomes over 24 weeks.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 3","pages":"e70149"},"PeriodicalIF":2.5,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body Weight Changes and Associated Social Factors in Newly Recruited Students at a Mexican Public University.","authors":"Wendy Paola Gastélum Espinoza, Alma Marlene Guadrón Llanos, Gisela Duarte de la Peña, Francisco Castro Apodaca, Loranda Calderón Zamora, Dalia Magaña Ordorica, Yuridia Chaidez Fernández, Javier Abednego Magaña Gómez","doi":"10.1002/osp4.70102","DOIUrl":"10.1002/osp4.70102","url":null,"abstract":"<p><strong>Introduction: </strong>The transition from high school to college involves lifestyle changes that can lead to increased body weight, a phenomenon commonly referred to as the Freshman 15. Although educational settings may differ across countries, this period could also present a risk of weight gain.</p><p><strong>Objective: </strong>To determine the weight gain in Mexican students during the transition from high school to a public university and identify the primary associated modifiable factors.</p><p><strong>Methods: </strong>Two hundred twenty-six students of both sexes, aged 17-21 years, were evaluated at the beginning and end of the first semester. Anthropometric characteristics, lifestyle habits, and self-perceived stress were analyzed. Intra-subject differences were assessed using the general linear model with repeated measures, and categorical variables were evaluated using non-parametric tests.</p><p><strong>Results: </strong>A significant weight increase of 0.8 kg was observed regardless of sex. Adolescents who ate under 20 min or lived in a rooming house without appliances exhibited the highest weight gain. Regression analyses revealed that female sex (<i>β</i> = -0.929, <i>p</i> = 0.008) and eating time of 21 min or more (<i>β</i> = 0.756, <i>p</i> = 0.050) were significantly associated with body weight change. In the multiple regression model, only sex remained a significant factor (<i>p</i> = 0.018).</p><p><strong>Conclusions: </strong>Weight gain in university students, especially in men, highlights this stage as a vulnerable period. It is essential to study habits and behaviors according to gender to design interventions that promote healthy eating. Further research is needed to identify modifiable factors associated with weight gain.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 2","pages":"e70102"},"PeriodicalIF":2.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secular Trends and Prognostic Value of the Body Shape Index in U.S. Adults.","authors":"Shuang Li, Yuchen Zhong, Yan Liu, Meixia Xiao, Shengming Shi","doi":"10.1002/osp4.70148","DOIUrl":"10.1002/osp4.70148","url":null,"abstract":"<p><strong>Objective: </strong>A Body Shape Index (BSI), previously developed and evaluated as an improvement over traditional adiposity measures for predicting health risks, has not been comprehensively characterized with respect to its temporal trends, population disparities, and prognostic value in the United States.</p><p><strong>Methods: </strong>This analysis examined data from 47,762 adults across 10 NHANES cycles (1999-2018). BSI trends were assessed across demographic and health-related subgroups. All-cause mortality risk was evaluated using Cox regression, with adjustment for multiple confounders. Interaction and restricted cubic spline analyses explored effect modification and nonlinearity.</p><p><strong>Results: </strong>Mean BSI increased significantly over the two decades. Disparities persisted or widened over time. Elevated BSI was independently associated with higher mortality risk, particularly above the median, with a nonlinear escalation in risk at higher BSI levels. The impact of high BSI on all-cause mortality was stronger in males and varied by race/ethnicity, while lower BSI showed no protective effect.</p><p><strong>Conclusions: </strong>BSI demonstrates a rising trend and persistent disparities among U.S. adults, with high BSI independently predicting adverse all-cause mortality in a nonlinear manner. These findings from the analyzed data supported the utility of BSI in risk stratification and highlighted the need for targeted interventions. Future research should explore BSI's role in public health strategies.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 ","pages":"e70148"},"PeriodicalIF":2.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Treatment Pathways and Implementation in Health Systems.","authors":"Ariana M Chao, Stephanie Walsh, Pamela R Rama, Jason M Samuels","doi":"10.1002/osp4.70142","DOIUrl":"10.1002/osp4.70142","url":null,"abstract":"<p><strong>Background: </strong>Although clinical practice guidelines are valuable for managing obesity and should be the foundation for health system protocols for screening, diagnosis, and treatment, these guidelines need to be translated and implemented within clinical care pathways that account for organizations' processes, structures, and cultures. Variation in resources across systems is another challenge.</p><p><strong>Methods: </strong>A narrative review was undertaken to assess how obesity treatment pathways can support health systems and HCPs in informed decision-making for obesity management, and to offer practical considerations for developing and implementing health care system treatment pathways.</p><p><strong>Findings: </strong>Little publicly available information exists on developing and implementing obesity treatment pathways in clinical practice within health systems. This review discusses the key elements of obesity care, including screening, diagnosis, treatment, and monitoring, and outlines the roles and responsibilities of health care professionals within each step of the pathway.</p><p><strong>Conclusion: </strong>This review offers resources and considerations for developing and implementing obesity care pathways in primary care, specialty care, and various other settings to assist health systems and health care professionals in making informed, evidence-based decisions in obesity management.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 ","pages":"e70142"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Evaluation of the Metabolic and Bariatric Surgery Initiative for Patients With Obesity and Comorbid Diabetes in Queensland.","authors":"Paul Scuffham, Katie Wykes, Jody Paxton","doi":"10.1002/osp4.70144","DOIUrl":"10.1002/osp4.70144","url":null,"abstract":"<p><strong>Background: </strong>Metabolic and bariatric surgery is the most effective long-term treatment for patients with obesity; however, access to publicly funded surgery in Australia has been limited despite strong evidence of clinical benefit. The Bariatric Surgery Initiative (BSI) was established to improve equitable access for people with obesity and type 2 diabetes, but its long-term economic value has not been evaluated. This study assessed the cost-effectiveness of metabolic and bariatric surgery compared with usual medical care to inform health-system decision-making.</p><p><strong>Methods: </strong>A Markov model was developed to simulate health outcomes and costs over the rest of life for patients with BSI. The model had five health states representing BMI classes. Costs obtained from the BSI for the surgical procedure were used and long-term costs for BMI classes were drawn from the literature. Quality of life (utility) weights were obtained from the BSI as were outcomes at 12 months following surgery. A Usual Care comparison group was developed from the literature and long-term costs were applied to both groups depending on the BMI class. Incremental cost-effectiveness ratios were estimated and sensitivity analyses were undertaken from the perspective of the Australian public health system.</p><p><strong>Results: </strong>The base-case analysis demonstrated that MBS was the preferred strategy that is, better health outcomes (2.5 QALYs gained) and lower costs (cost-savings of $67,000). Scenario analyses identified that younger age groups have greater health benefits and higher BMI classes have greater cost-savings.</p><p><strong>Conclusions: </strong>MBS is a cost-effective intervention for patients with obesity class 2 and diabetes. The BSI was an efficient service that provided the necessary information to develop the local evidence.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 ","pages":"e70144"},"PeriodicalIF":2.5,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}