Obesity Science & Practice最新文献

{"title":"Negative Consequences of Removing GLP-1 RA Obesity Coverage: A Cross-Sectional Cohort Comparison Study.","authors":"Jackson M Francis, Deepali K Ernest, Aparajita Chandrasekhar, Grant Herrington, Chellse Gazda, Luyu Xie, M Sunil Mathew, Marianne Olaniran, Sarah E Messiah, Jaime P Almandoz","doi":"10.1002/osp4.70123","DOIUrl":"10.1002/osp4.70123","url":null,"abstract":"<p><strong>Objective: </strong>GLP-1 receptor agonist (GLP-1 RA) coverage decisions for obesity have major health and economic implications. This study examined how loss of GLP-1 coverage affected employee perceptions of their employer and workforce stability.</p><p><strong>Methods: </strong>This study analyzed data from employees of a healthcare system that discontinued GLP-1 obesity medication coverage. Outcomes were evaluated using chi-square/Fisher's exact tests and multivariable logistic regression.</p><p><strong>Results: </strong>Two hundred forty-seven adults prescribed GLP-1 for obesity who lost coverage (mean age 49.27 years-SD: 9.89, BMI 32.85 kg/m²-SD: 8.49); 90.28% were female, 40.08% non-Hispanic White, 30.36% non-Hispanic Black, 19.84% Hispanic, and 9.72% Other. Following loss, 80.57% reported worsened employer perceptions, 17.81% considered changing jobs, 49.39% felt devalued, and 64.38% believed their employer didn't value their health. Burnout was common (88.67% past year; 65.19% past month). NHB and Hispanic employees were less likely than NHW to report worsened employer relationships (aOR = 0.29 and 0.34), while those with incomes ≥ $150,000 were 2.5x as likely to report negative impact (aOR = 2.57).</p><p><strong>Conclusion: </strong>Loss of GLP-1 coverage was linked to reduced employee satisfaction, increased burnout, and greater turnover risk. Lower reported impact among NHB and Hispanic employees may reflect disparities in perceived job mobility. These consequences may undermine workforce stability and offset cost savings that motivate coverage restrictions.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 2","pages":"e70123"},"PeriodicalIF":2.5,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355966","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":"Prevalence of Therapeutic Inertia in the Management of Overweight and Obesity in Patients With a Diagnosis of Type 2 Diabetes Who Are Followed up by Primary Care Physicians.","authors":"Pablo Aschner, Diana Henao-Carrillo","doi":"10.1002/osp4.70121","DOIUrl":"10.1002/osp4.70121","url":null,"abstract":"<p><strong>Introduction: </strong>Information on therapeutic inertia (TI) in weight loss in people with type 2 diabetes (T2D) is limited.</p><p><strong>Objective: </strong>To describe the prevalence of TI in the management of overweight/obesity in people with T2D undergoing primary care program (PCP) follow-up and weight changes according to the prescribed treatment.</p><p><strong>Methods: </strong>A retrospective longitudinal study was conducted in patients with T2D with body mass index (BMI) ≥ 25 kg/m² followed by PCP. The following data were obtained from medical records at the first assessment, 6 and 12 months: anthropometric data, HbA1c, medications added according to their effect on weight, and specialist referrals (nutrition and metabolic and bariatric surgery).</p><p><strong>Results: </strong>A total of 128 patients were included (age 65.5 ± 11.7 years, HbA1c 7.8 ± 1.7%, BMI 33.1 ± 5.7 kg/m²). The mean HbA1c at the end of follow-up was 7.4% ± 1.4%. Twenty-five percent achieved ≥ 5% weight loss after 12 months. The proportion of patients without weight-loss interventions increased from 59% in the first assessment to 86% and 89% after 6 and 12 months of follow-up. Patients who lost ≥ 5% of their weight were more likely to be referred to dietary counseling at program entry (37.5% vs. 23.4%) and at 6 months (18.8% vs. 6.4%) compared to patients who gained weight. In addition, the prescription of SGLT2 inhibitors/GLP1-receptor agonist was higher in this group at 6 months (49.3% vs. 10.7%).</p><p><strong>Conclusions: </strong>Although there was a reduction in HbA1c, the TI for prescribing weight-loss interventions was high. This suggests the importance of including weight loss as a therapeutic goal alongside lowering HbA1c in primary care.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 2","pages":"e70121"},"PeriodicalIF":2.5,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12952996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355997","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":"Proximal and Distal Factors Associated With Obesity in Childhood: An Exploratory Structural Equation Model.","authors":"Joseph A Skelton, Erinn T Rhodes, Sarah E Hampl, Ihuoma Eneli, Edward H Ip","doi":"10.1002/osp4.70124","DOIUrl":"10.1002/osp4.70124","url":null,"abstract":"<p><strong>Background: </strong>Obesity in childhood is complex; structural equation modeling (SEM) offers an approach to ascertain complicated relationships between weight and proximal (health behaviors, child health) and distal (family/household, community) variables. The objective of the study was to use SEM to map the influence of different etiological clusters on obesity in childhood.</p><p><strong>Methods: </strong>Secondary analysis of baseline data from patients and parents enrolled in a multi-site study of pediatric weight management was conducted. The primary outcome was weight status (utilizing percentage above the 95th percentile BMI, %95BMI). SEM was used to evaluate the influences of variables proximal and distal to child weight within the context of the Ecological Model of obesity in childhood.</p><p><strong>Results: </strong>Complete data on 375 child-parent dyads were imputed. Proximal factors (child stress and mobility, parent BMI) were significantly related to %95BMI; some distal factors (family level) did not have a direct effect on %95BMI, but did indirectly through proximal factors (such as child stress). Other distal factors (neighborhood deprivation represented by the Area Deprivation Index) were significantly related to %95BMI and family-level factors.</p><p><strong>Conclusions: </strong>Except for the distal factor of neighborhood deprivation, proximal factors were the drivers of weight status. Distal factors did have indirect effects via proximal factors. SEM provides a means to investigate the complex contributors to childhood obesity, and could identify key leverage points for intervention.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 2","pages":"e70124"},"PeriodicalIF":2.5,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12948713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326858","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":"Aligning Biomedical Research With Neurodiversity to Support the Metabolic Health of Autistic Individuals.","authors":"Emily Hotez, A Janet Tomiyama","doi":"10.1002/osp4.70117","DOIUrl":"10.1002/osp4.70117","url":null,"abstract":"<p><p>Autistic individuals represent approximately 1 in 31 people in the United States and experience disproportionately high rates of obesity, type 2 diabetes, cardiovascular disease, and feeding and eating challenges, alongside reduced life expectancy. However, evidence-based metabolic health interventions for autistic populations remain sparse. This Perspective synthesizes evidence on two interconnected barriers that limit metabolic health research in the autism field: (1) lack of accessible biomedical research methodologies and (2) insufficient attention to mechanisms underlying poor metabolic health in this population, including chronic stress and weight stigma. Drawing on principles from neurodiversity, Universal Design for Research, and the Academic Autism Spectrum Partnership in Research and Education (AASPIRE) guidelines, we outline a neuro-affirming paradigm that can improve metabolic health research in the autism field. Finally, we provide phase-by-phase practical recommendations for researchers, spanning study design, measure development, recruitment, consent, screening, data collection, and interpretation. Aligning metabolic health research with neuro-affirming principles can generate more rigorous, representative, and ethically grounded evidence and ultimately support more meaningful improvements in metabolic health and overall well-being for autistic individuals across the life course.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70117"},"PeriodicalIF":2.5,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106397","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":"Development of the Weight and Emotions Scale (WES).","authors":"Chisom Kanu, Miriam Kimel, Iris Goetz, Lisa M Neff, Kristina S Boye, Marissa Stefan, Jessica Jordan","doi":"10.1002/osp4.70119","DOIUrl":"10.1002/osp4.70119","url":null,"abstract":"<p><strong>Objective: </strong>Obesity and overweight are associated with significant psychosocial burden. Existing patient-reported outcome (PRO) measures only assess a subset of emotion-related concepts that are relevant to individuals living with these conditions. The Weight and Emotions Scale (WES) was developed to enable robust evaluation of the impact of obesity or overweight and the benefits of treatment on patients' emotional functioning.</p><p><strong>Methods: </strong>The WES was developed based on findings from interviews with participants (<i>N</i> = 40) exiting a Phase 2 trial for retatrutide (NCT04881760), a targeted literature review, and interviews with clinicians specialized in obesity medicine (<i>N</i> = 3). Cognitive interviews were conducted with adults with obesity/overweight and ≥ 1 obesity-related complication (<i>N</i> = 20) to evaluate the WES content.</p><p><strong>Results: </strong>All cognitive interview participants expressed a positive overall impression of the WES, reported that they understood the instructions, response options, and recall period, and that the questions were easy to answer. Most items (75%) were understood by all the participants and were rated as \"very important\" or \"moderately important\" by ≥ 75% of the participants. The WES is a new 16-item PRO measure evaluating 13 emotion-related concepts.</p><p><strong>Conclusions: </strong>The WES may be used in clinical trials, observational research, or clinical practice to robustly assess the impact of obesity or overweight and the benefits of treatment on patients' emotional functioning.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70119"},"PeriodicalIF":2.5,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12832084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053270","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":"A Multi-Level Intervention to Address Childhood Obesity in Rural Hispanic Communities.","authors":"Linda K Ko, Eileen Rillamas-Sun, Mario Kratz, Eligio Jimenez, Sou Hyun Jang, Jason A Mendoza, Sonia Bishop, Lan Xiao","doi":"10.1002/osp4.70116","DOIUrl":"10.1002/osp4.70116","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric obesity disproportionately affects children of lower socioeconomic status, racial and ethnic minorities, and rural communities, and is influenced by social and physical environments. Community-engaged interventions can address pediatric obesity and have been implemented in rural settings for other conditions, but few have specifically targeted rural childhood obesity. Together We STRIDE study is a community-based trial designed to test the effectiveness of a multi-level obesity prevention intervention in Hispanic children living in rural communities.</p><p><strong>Methods: </strong>The trial enrolled 653 children (8-12 years old). The 13-month (March 2017-April 2018) multi-level intervention included comic books, nutrition and physical activity (PA) classes, media literacy education and PA breaks, and an open-street community program (Ciclovía). The primary outcome was between-group differences in BMI <i>z</i>-score, measured at baseline, 6 months, and 18 months.</p><p><strong>Results: </strong>There were no significant between-group differences in BMI <i>z</i>-scores and BMI-for-age percentile relative to 95th percentile at 6 months or 18 months follow up. The mean difference in BMI <i>z</i>-score between intervention and comparison communities was -0.02 (95% CI -0.05, 0.02; <i>p</i> = 0.31) at 6 months and 0.03 (95% CI -0.03, 0.09; <i>p</i> = 0.32) at 18 months, respectively. BMI <i>z</i>-scores decreased progressively with increased exposure to intervention components (unadjusted <i>p</i>-trend = 0.008 and adjusted <i>p</i>-trend = 0.009).</p><p><strong>Conclusions: </strong>Although this multi-level community-based intervention did not show an overall intervention effect on BMI <i>z</i>-scores, greater engagement with the intervention components was associated with higher reductions in BMI <i>z</i>-scores. The findings underscore both the promise and the challenges of community-based obesity prevention interventions in rural communities.</p><p><strong>Trial registration: </strong>NCT02982759 (Together We STRIDE) retrospectively registered during study recruitment.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70116"},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12828269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146053228","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":"Recent Insights Into Circulating Adipokines in Obesity: Systematic Review and Meta-Analysis.","authors":"Sunita Sunita, Mohammad Ghozali, Mohammad Rizki Akbar, Annisa Dewi Nugrahani, Iis Inayati Rakhmat, Siti Nur Fatimah, Yuni Susanti Pratiwi, Eko Fuji Ariyanto, Gaga Irawan Nugraha, Mas Rizky A A Syamsunarno, Tri Hanggono Achmad","doi":"10.1002/osp4.70113","DOIUrl":"10.1002/osp4.70113","url":null,"abstract":"<p><strong>Background: </strong>Adipokines are dysregulated in obesity and exacerbate proinflammatory conditions. Although several studies have investigated adipokine levels in obesity, their findings have been inconsistent, leaving the precise nature of these alterations uncertain. This systematic review and meta-analysis aimed to provide an updated overview of circulating adipokines, particularly adiponectin, leptin, fibroblast growth factor 21 (FGF21), growth differentiation factor 15 (GDF15), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in the context of obesity.</p><p><strong>Methods: </strong>This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and PROSPERO registration (CRD42024525103). PubMed/MEDLINE, Scopus, and <i>Journal of Clinical Investigation</i> databases were searched from inception to August 25, 2025. Eligible observational studies were assessed using the ROBINS-I and GRADE frameworks. Standardized mean differences (SMDs) were calculated using a random-effects model.</p><p><strong>Results: </strong>From 2378 records, 30 and 16 studies were included in the review and meta-analysis, respectively. Adiponectin levels were significantly lower in persons with obesity than in those with normal weight (<i>p</i> = 0.007). Conversely, leptin, TNF-α, and FGF21 levels were significantly higher in persons with obesity (<i>p</i> < 0.01). No significant differences were found for GDF15 (<i>p</i> = 0.62) and IL-6 (<i>p</i> = 0.17).</p><p><strong>Conclusions: </strong>Adiponectin, leptin, TNF-α, and FGF21 show consistent directionality and may serve as robust biomarkers in obesity-related risk profiling. Conversely, GDF15 and IL-6 exhibit context-dependent variability. Further prospective cohort studies are warranted to better understand these adipokines, as persons with normal weight may still be at a high risk of cardiometabolic diseases.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70113"},"PeriodicalIF":2.5,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030424","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":"Plate Clearing and Body Mass Index: A Meta-Analysis.","authors":"Adrian Meule, Lisa Dietlmeier, David R Kolar","doi":"10.1002/osp4.70118","DOIUrl":"10.1002/osp4.70118","url":null,"abstract":"<p><strong>Background: </strong>Current food environments are characterized by larger food portions, which contribute to higher food consumption. Thus, habitually finishing meals by eating the entire portion (so-called plate clearing or plate cleaning) may lead to weight gain. However, findings have been mixed: some studies reported small, positive associations between self-reported plate clearing tendencies and body mass index, but other studies did not find a relationship or even reported a negative association.</p><p><strong>Methods: </strong>The current study performed a meta-analysis on the correlation between plate clearing tendencies and body mass index.</p><p><strong>Results: </strong>The pooled effect based on 22 samples was <i>r</i> = 0.04 (95% CI [-0.02, 0.10]), indicating no relationship between plate clearing and body mass index. A meta-regression indicated that the percentage of women as well as the type of self-report measure moderated the effect, suggesting that there might be a small, positive relationship between plate clearing and body mass index in men and when the Plate Clearing Tendency Scale was used.</p><p><strong>Conclusion: </strong>This meta-analysis does not indicate that habitual plate clearing relates to a higher body weight in general. While self-report biases cannot be excluded based on the current study, the absence of an observed association highlights the need for further exploration into why this relationship is not evident.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70118"},"PeriodicalIF":2.5,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12817134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146019452","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":"Joint Pain Outcomes After Metabolic and Bariatric Surgery in Patients With and Without Hypermobility.","authors":"Elke Schubert-Hjalmarsson, Lizette Albertsson, Ebba Englund, Monika Fagevik Olsén","doi":"10.1002/osp4.70115","DOIUrl":"10.1002/osp4.70115","url":null,"abstract":"<p><strong>Objective: </strong>Obesity increases the risk of musculoskeletal conditions, but retrospective studies have suggested that individuals with joint hypermobility experience more joint pain after metabolic and bariatric surgery and weight loss. Joint hypermobility is the ability of one or more joints to move beyond the normal range of motion. This study prospectively investigated postoperative joint pain and its association with joint hypermobility.</p><p><strong>Methods: </strong>A survey including the 5-Part Questionnaire (5PQ) and a self-developed joint pain questionnaire was completed prior to and 1 year after metabolic and bariatric surgery. Participants were categorized as having hypermobility based on the 5PQ.</p><p><strong>Results: </strong>Seventy-four participants completed both surveys; 15 reported hypermobility postoperatively, 59 did not. The two groups were similar in age, sex, pre-operative and postoperative weight, BMI, and weight loss. In the group without hypermobility, pain frequency significantly decreased in the neck, lumbar spine, hips, knees, ankles, and feet/toes, and they reported fewer painful body parts postoperatively. The hypermobility group did not report significant changes in pain frequency or number of painful joints. However, total pain frequency was not different between the groups.</p><p><strong>Conclusions: </strong>Weight loss after metabolic and bariatric surgery was associated with reduced joint pain only in patients without hypermobility. Participants with hypermobility tended to maintain pain in load-bearing joints, suggesting that joint hypermobility limits pain improvement. Targeted monitoring and muscle-strengthening interventions may benefit this population.</p><p><strong>Trial registration: </strong>The trial was registered in \"FoU in Sweden\" (Research and Development in Sweden) on May 1, 2015 (registration number: 202221) and in Clinical Trials June 8, 2018 (NCT03641027).</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70115"},"PeriodicalIF":2.5,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12800385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145990132","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":"Metabolic Outcomes in Patients With Type 2 Diabetes Prescribed Incretin-Based Therapy and Referred or Not to a Weight Management Clinic: A Single-Center Retrospective Analyses.","authors":"Kathleen M Robinson, Stephanie H Rodriguez, Cyril Pedagarla, Patrick Ten Eyck, Marcelo Correia, Ayotunde Dokun","doi":"10.1002/osp4.70114","DOIUrl":"10.1002/osp4.70114","url":null,"abstract":"<p><strong>Background: </strong>Incretin therapies yield strong metabolic improvements, but whether adding a weight-management (WM) clinic confers additional benefit beyond pharmacotherapy alone in routine care is unclear.</p><p><strong>Objective: </strong>Evaluate whether referral to WM clinic, alongside standard diabetes care, provides additional benefit for adults with type 2 diabetes (T2DM) and obesity treated with incretin therapies regarding changes in A1c, body weight, and LDL.</p><p><strong>Methods: </strong>Retrospective cohort study within an academic health system (2018-2023); adults with T2DM and obesity initiating an incretin were grouped by care model (diabetes care alone, DM, vs. diabetes care plus WM clinic, DM + WM). <i>N</i> = 1445 (DM <i>n</i> = 1,163, DM + WM <i>n</i> = 282). The DM + WM group was stratified based on the number of visits. Primary outcomes were change from baseline to last follow-up in A1c (%), body weight (kg), and LDL (mg/dL). Weighted linear models reported within-group changes and between-group adjusted mean differences with 95% CIs, controlling for baseline values and prespecified covariates (sex, race/ethnicity, age, comorbidity, medication categories, care period).</p><p><strong>Results: </strong>Among 1445 patients (DM <i>n</i> = 1163; DM + WM <i>n</i> = 282), both groups improved from baseline: weight -4.95 versus -6.00 kg, A1c -0.38% versus -0.37%, LDL -12.19 versus -11.60 mg/dL (all within-group <i>p</i> < 0.05). In adjusted models, the DM + WM (1 visit) group lost less weight than the DM group by +4.1 kg (95% CI 1.2-7.1 kg; <i>p</i> = 0.006) while the DM + WM (4 + visit) group lost more weight with of -4.4 kg (95% CI -6.7 to -2.0 kg, <i>p</i> = 0.0003). Other differences were not statistically significant: A1c + 0.01% (-0.27 to 0.28; <i>p</i> = 0.96), LDL + 0.58 mg/dL (-6.01 to 7.16; <i>p</i> = 0.86).</p><p><strong>Conclusion: </strong>Among adults starting incretin therapy in routine practice, significant improvements in A1c, weight, and LDL were observed. Patients attending one weight management visit lost less weight than those attending only the DM clinic, while those attending 4 + WM visits lost significantly more weight. Potential long-term effects of WM-based support were not assessed.</p>","PeriodicalId":19448,"journal":{"name":"Obesity Science & Practice","volume":"12 1","pages":"e70114"},"PeriodicalIF":2.5,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12791153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966648","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}