Obesity最新文献

{"title":"Tirzepatide for the Maintenance of Body Weight Reduction: Rationale, Design, and Baseline Characteristics of SURMOUNT-MAINTAIN","authors":"Deborah B. Horn,&nbsp;Louis J. Aronne,&nbsp;Sean Wharton,&nbsp;Harold E. Bays,&nbsp;Elisa Gomez-Valderas,&nbsp;Avigdor D. Arad,&nbsp;Palash Sharma,&nbsp;Julia P. Dunn,&nbsp;Cagri Senyucel,&nbsp;Clare J. Lee","doi":"10.1002/oby.70014","DOIUrl":"10.1002/oby.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>SURMOUNT-MAINTAIN aims to evaluate the efficacy and safety of reducing the tirzepatide dose and/or continuing the maximum tolerated dose (MTD) versus placebo in maintaining body weight (BW) reduction achieved with tirzepatide MTD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This Phase 3b, multicenter, randomized, parallel-arm, double-blinded, placebo-controlled, 52-week clinical trial is in progress comparing treatment with once weekly tirzepatide (5 mg and/or MTD of 15 mg or 10 mg) versus placebo in achieving BW reduction maintenance from the initial 60-week open-label weight-loss period on tirzepatide MTD, in adults with obesity (BMI ≥ 30 kg/m² or ≥ 27 kg/m² with ≥ 1 obesity-related comorbidity, excluding type 2 diabetes). The primary endpoint is percent maintenance of BW reduction achieved during the weight-loss period at Week 112 among those who reached a BW plateau (i.e., &lt; 5% BW change) between Weeks 48 and 60.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants are mostly female (65%) with a mean ± SD age of 47 ± 13 years, BW 114 ± 27 kg, BMI 40 ± 8 kg/m², and waist circumference 119 ± 18 cm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SURMOUNT-MAINTAIN trial will evaluate whether reducing or continuing the tirzepatide dose as a long-term treatment option may help maintain the reduced BW initially achieved with tirzepatide MTD versus switching to placebo. Combined, this study may provide additional evidence to help tailor patient-centered strategies for maintenance of BW reduction in adults living with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06047548</p>\u0000 \u0000 <div>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1873-1885"},"PeriodicalIF":4.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016912","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":"Projecting Global Trends and Inequalities in Adult Overweight and Obesity, 2023–2040: Findings From the NCD-RisC Database","authors":"Jinli Liu,&nbsp;Zeping Fang,&nbsp;Qianhui Lu,&nbsp;Yanan Wang,&nbsp;Lei Zhang","doi":"10.1002/oby.24358","DOIUrl":"10.1002/oby.24358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study quantifies the global burden of overweight and obesity, projects future trends, and examines associated health inequalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overweight and obesity burden data were obtained from the NCD-RisC database. Trends from 1990 to 2022 were analyzed, and a Bayesian model was used to project changes for 2023–2040. Cross-national health inequalities were measured using the slope index of inequality (SII) and the relative concentration index (RCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Globally, overweight prevalence rose from 17.50% in 1990 to 28.00% in 2022 (average annual percentage change [AAPC] = 1.48%) and is projected to reach 43.97% by 2040 (AAPC = 1.13%). Obesity prevalence grew from 6.44% to 16.06% (AAPC = 2.46%) and is projected to surge to 38.96% by 2040 (AAPC = 4.96%). The SII for overweight burden dropped from 33.74% in 1990 to 16.24% in 2022, and it is projected to reverse to −2.42% by 2040. For obesity (BMI, ≥ 30.0 kg/m²) and mild obesity (BMI, 30.0–34.9 kg/m²), the SII declined from 20.12% to 18.58% and from 14.22% to 10.02%, respectively, with further drops to 9.35% and −1.70% by 2040. From 1990 to 2040, the share of the global prevalence burden of overweight and obesity in countries with the lowest GDP per capita rose from 15% to 22% and from 6% to 26%, respectively. The relative gradient inequality, measured by RCI, also showed similar findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The global burden of overweight and obesity has significantly increased from 1990 to 2040. Health inequalities decreased from 1990 to 2022, with the burden mainly in higher-income countries. However, by 2040, the burden of overweight and mild obesity is projected to shift to lower-income countries, highlighting the need for targeted health policies and interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1955-1967"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983463","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":"Real-World Efficacy and Safety of Setmelanotide in Adults With Monogenic or Syndromic Obesity: A Prospective Cohort Study","authors":"Francois Mifsud,&nbsp;Sarah Chalopin,&nbsp;Emilie Guillon,&nbsp;Pauline Faucher,&nbsp;Jean Muller,&nbsp;Johanne Le Bihan,&nbsp;Karine Clément,&nbsp;Christine Poitou","doi":"10.1002/oby.70002","DOIUrl":"10.1002/oby.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The melanocortin-4 receptor agonist setmelanotide has demonstrated effectiveness in phase 3 clinical trials for patients with monogenic obesity caused by biallelic variants in the leptin receptor (LEPR) and pro-opiomelanocortin (POMC), as well as for individuals with Bardet–Biedl syndrome (BBS). However, real-world evidence remains limited. This study evaluates the long-term effectiveness and safety of setmelanotide in patients who received treatment under a pre-marketing early-access authorization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This ongoing prospective monocentric cohort includes 17 patients with obesity due to BBS (<i>n</i> = 11) or biallelic variants in <i>LEPR</i> (<i>n</i> = 4) or <i>POMC</i> (<i>n</i> = 2) who either started setmelanotide in routine care between 2022 and 2024 or continued therapy after participating in the RM-493-022 clinical trial. The average follow-up time was 14.4 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients experienced a clinically significant weight reduction of 20% from their highest pre-treatment weight within the first year. Those previously treated in a clinical trial maintained their weight loss over time. Additionally, eating behavior improved, with significant reductions in hunger (−62%), food craving (−41%), and external eating evaluated by DEBQ. The overall safety profile was consistent with phase 3 trials data, without any new safety signals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings confirm the drug's long-term clinical benefit and safety profile in a routine-care setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1865-1872"},"PeriodicalIF":4.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983688","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 Metal Mixtures During Early Pregnancy With Midlife Obesity and Body Composition: A Prospective Study","authors":"Mingyu Zhang,&nbsp;Izzuddin M. Aris,&nbsp;Andres Cardenas,&nbsp;Sheryl L. Rifas-Shiman,&nbsp;Pi-I Debby Lin,&nbsp;Long H. Ngo,&nbsp;Emily Oken,&nbsp;Stephen P. Juraschek,&nbsp;Marie-France Hivert","doi":"10.1002/oby.24368","DOIUrl":"10.1002/oby.24368","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the prospective associations of metal mixtures during pregnancy with midlife adiposity and explore metal-folate interactions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 500 participants from Project Viva, we measured six non-essential metals (arsenic, barium, cadmium, cesium, mercury, and lead) and five essential metals (copper, magnesium, manganese, selenium, and zinc) in red blood cells and folate in plasma collected during early pregnancy (mean gestational age: 10.0 weeks; mean age: 32.9 years). We assessed midlife (mean age: 51.2 years) adiposity using BMI and dual-energy X-ray absorptiometry (DXA) measures. We used multivariable-adjusted linear and multinomial logistic regression models to analyze individual exposures and Bayesian kernel machine regression to examine exposure mixtures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher arsenic, cesium, and mercury levels were associated with lower midlife DXA percentage fat, total fat mass index, and/or trunk fat mass index, even after adjustments for diet in pregnancy. We observed an antagonistic interaction between folate and arsenic: arsenic was associated with higher obesity risk at lower folate levels but lower obesity risk at higher folate levels. The essential metal mixture tended to be associated with lower midlife BMI and obesity risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher pregnancy levels of arsenic, cesium, mercury, and the mixture of essential metals were associated with lower midlife adiposity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1984-1994"},"PeriodicalIF":4.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984421","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":"Alcoholic Use Disorder Outcomes After Roux-en-Y Gastric Bypass in Patients Taking GLP-1 RAs: A Multicenter Analysis","authors":"Olanrewaju Adeniran,&nbsp;Luis M. Nieto,&nbsp;Chima Amadi,&nbsp;Katherine Shepherd,&nbsp;Joshua Kirkpatrick,&nbsp;Kanith Farah,&nbsp;Farirai Marwizi,&nbsp;Budoor Alqinai,&nbsp;Sharon I. Narvaez,&nbsp;Samuel Mensah,&nbsp;Ayowumi Adekolu,&nbsp;Ethan M. Cohen,&nbsp;Raja S. Khan,&nbsp;Swapna Gayam,&nbsp;Lawrence E. Tabone,&nbsp;Laura Davisson","doi":"10.1002/oby.70001","DOIUrl":"10.1002/oby.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Roux-en-Y gastric bypass (RYGB) has been linked with increased alcohol-related outcomes, whereas glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been associated with reduced risks. We performed the first multicenter retrospective cohort study to identify alcohol use outcomes of GLP-1 RAs post RYGB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using TriNetX, adults (≥ 18 years old) with obesity (BMI ≥ 30 kg/m²) who underwent RYGB between January 1, 2019, and May 31, 2023, were identified. Two cohorts were analyzed: patients initiated on GLP-1 RA versus non-GLP-1 RA users. Patients with other liver diseases and other bariatric surgeries were excluded. Covariates were balanced via propensity score matching (PSM). Participants were followed for at least 1 year post RYGB and GLP-1 RA initiation. Outcomes include the risk of alcohol use disorders (AUD), alcohol liver diseases (ALD), and all-cause mortality. Hazard ratio (HR) was calculated through Cox regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After PSM, 3438 were matched in each cohort. GLP-1 RA initiation was associated with a reduced incidence rate of AUD versus control (1.1% vs. 1.8%) (HR 0.77, [95% CI: 0.549–0.840, <i>p</i> = 0.041]) and all-cause mortality (1.2% versus 3.9%) (HR 0.497, [95% CI: 0.346–0.715, <i>p</i> = 0.039]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Post RYGB, GLP-1 RAs provide the potential to reduce AUD and all-cause mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1886-1894"},"PeriodicalIF":4.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984427","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":"Multimodal Neuroimaging of Brain Structure, Metabolism, and Function in Obesity: Current Landscape and Future Perspectives","authors":"Tao Ju,&nbsp;Zhen Li,&nbsp;Xiaozu Zhang,&nbsp;Yang Liu,&nbsp;Xiaotian Gao,&nbsp;Haimo Zhang,&nbsp;Xizhen Wang,&nbsp;Xiaodong Sun,&nbsp;Xiaoli Wang","doi":"10.1002/oby.24353","DOIUrl":"10.1002/oby.24353","url":null,"abstract":"<div>\u0000 \u0000 <p>Obesity is a systemic disease that not only increases the incidence of diabetes and cardiovascular disease but also contributes to central nervous system disorders such as cognitive impairment, depression, and anxiety. Neuroimaging studies have confirmed that obesity leads to various forms of brain damage, as well as abnormalities in the function and metabolism of different brain regions. Multimodal neuroimaging, a collection of detection tools capable of visualizing neural diseases, has shown potential in diagnosing various brain disorders, and it provides insights from multiple perspectives to explore the pathological mechanisms of brain damage associated with obesity. Structural imaging techniques within multimodal imaging have identified changes in the volume and microstructure of the brain's gray and white matter. Functional imaging has detected abnormal activation and disrupted circuits in specific brain regions, while metabolic imaging has revealed neurochemical changes in the brain. In this review, we provide an overview of multimodal neuroimaging in obesity-related brain diseases, systematically analyzing these diseases from three aspects: structure, metabolism, and function. Additionally, we introduce novel multimodal imaging techniques that hold potential but have not yet been applied to obesity-related studies, aiming to provide a theoretical foundation for future clinical diagnosis and treatment.</p>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1833-1844"},"PeriodicalIF":4.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984456","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":"Correction to “MicroRNA Profiling in Adipose Before and After Weight Loss Highlights the Role of miR-223-3p and the NLRP3 Inflammasome”","authors":"","doi":"10.1002/oby.70007","DOIUrl":"10.1002/oby.70007","url":null,"abstract":"<p>\u0000 \u0000 <span>Macartney-Coxson, D.</span>, <span>Danielson, K.</span>, <span>Clapham, J.</span>, et al., “ <span>MicroRNA Profiling in Adipose Before and After Weight Loss Highlights the Role of miR-223-3p and the NLRP3 Inflammasome</span>,” <i>Obesity</i> <span>28</span> (<span>2020</span>): <span>570</span>–<span>580</span>, https://doi.org/10.1002/oby.22722.\u0000 </p><p>In Table 2 of this article, the headings for columns 3 and 6 and footnote “a” are incorrect.</p><p>Below is the correct Table 2.</p><p>In addition, in the <i>Methods</i> section, under the heading \"Differential expression analysis of miRNA arrays,\" the text should read: “Fold change was calculated using 2^{absolute log2FC}. Decreased fold change (i.e. less expression after vs. before gastric bypass) is represented as −2^{absolute log2FC}.”</p><p>Under the \"RT-qPCR\" heading, in two instances, the text should read: “Fold change in expression between time points was calculated for each paired sample using 2^−ΔΔCt. For values &lt; 1 (indicating a decrease in gene expression after vs. before gastric bypass and weight loss) the negative reciprocal of 1/2^−ΔΔCt was calculated. Mean relative fold change for a given tissue and gene was calculated using each of these individual fold change values from the paired samples.”</p><p>We apologize for these errors.</p>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"2014-2015"},"PeriodicalIF":4.7,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884694","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":"Health care resource utilization and health care costs among digital weight-loss intervention participants and nonparticipants","authors":"Casey Tak,&nbsp;Paige Thompson,&nbsp;Jessica L. Morse,&nbsp;Meaghan McCallum","doi":"10.1002/oby.24337","DOIUrl":"10.1002/oby.24337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of this study was to compare health care resource utilization (HRU), health care costs, and glucagon-like peptide-1 (GLP-1) agonist use among working US adults who engaged in Noom Weight, a smartphone-based lifestyle intervention for weight management, to individuals offered Noom who did not enroll.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Insurance claims data were used to conduct retrospective analyses of 723 Noom participants matched via propensity scores and compared to 723 non-Noom participants at 6 months post index.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to nonparticipants, Noom participants had significantly lower HRU, medical and pharmacy costs, and GLP-1 agonist use in the 6-month post-index period. On average, Noom participants had 3.2 fewer outpatient visits, 0.34 fewer emergency department visits, 0.25 fewer inpatient visits, and 0.012 fewer surgeries than non-Noom participants (all <i>p</i> values &lt;0.001). Noom participants’ health care costs were $831 lower than non-Noom participants. Relative to non-Noom users, Noom participants also had 42% fewer claims for GLP-1 agonists (<i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared to matched nonparticipants, Noom participation was associated with lower HRU, health care costs, and GLP-1 agonist use at 6 months post index. Results of this study support Noom as a cost-effective and HRU-lowering digital weight-management program for working adults in the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 9","pages":"1637-1644"},"PeriodicalIF":4.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850229","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":"Screening for MASLD and Advanced Fibrosis Among Patients With Obesity: A Cost-Effectiveness Analysis","authors":"Arpan Mohanty,&nbsp;Yin Wang,&nbsp;Charles Stoecker","doi":"10.1002/oby.70005","DOIUrl":"10.1002/oby.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The study aimed to compare the cost-effectiveness of various strategies for screening for MASLD-related advanced hepatic fibrosis (fibrosis stage &gt; 2) using the fibrosis-4 index (FIB-4) and liver stiffness measurement (LSM) by transient elastography (TE) in persons with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We created a decision-analytic model comparing three screening strategies: no screening, TE, and FIB-4 followed by TE. We used a Markov transition model to track liver state, with prevalence and transition probabilities specific to the population with obesity. If MASLD was detected, patients were treated with resmetirom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found an incremental cost-effectiveness ratio (ICER) of $234,781 (95% CI: $232,581, $235,608) when comparing TE to no screening with a 10-year interval. We note the ICER of $234,673 (95% CI: $234,033, $235,072) when comparing TE to FIB-4+TE. In multivariate simulations, we found no screening was most likely to be cost-effective for willingness-to-pay for QALY below approximately $250,000.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results suggest routine screening for MASLD in obesity clinics is not cost-effective with resmetirom as the available treatment. A prescreening with FIB-4 before TE did not increase economic efficiency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1845-1848"},"PeriodicalIF":4.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984070","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":"Dietary Macronutrient Composition and Protein Concentration for Weight Loss Maintenance","authors":"Hanyue Zhang,&nbsp;Aikaterina Vasileiou,&nbsp;Dominique Searle,&nbsp;Sofus C. Larsen,&nbsp;Alistair M. Senior,&nbsp;Faidon Magkos,&nbsp;Leigh C. Ward,&nbsp;Graham Horgan,&nbsp;Inês Santos,&nbsp;António L. Palmeira,&nbsp;Stephen J. Simpson,&nbsp;David Raubenheimer,&nbsp;R. James Stubbs,&nbsp;Berit L. Heitmann","doi":"10.1002/oby.24370","DOIUrl":"10.1002/oby.24370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To examine the association between dietary macronutrient composition and 12-month weight loss maintenance (WLM) in adults who achieved initial weight loss (≥ 5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort analysis used 12-month follow-up data from the Navigating to a Healthy Weight trial. Macronutrient composition (%) was assessed using a 4-day, 24-h dietary recall. Food sources were categorized as discretionary foods, lean meat, vegetables, fruit, grains, and dairy. Primary outcomes included 12-month changes in body weight, fat mass index (FMI), waist-to-height ratio (WHtR), and hip-to-height ratio (HHtR). A nutritional geometry approach was used to examine individual and interactive associations of macronutrient intake, visualizing as response surfaces.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1518 participants (69.8% women; mean age 45 ± 12 years), mean macronutrient composition was 20.6% protein, 33.8% fat, and 43.1% carbohydrate. Protein energy percentage was inversely associated with energy intake (β: −0.33; 95% CI: −0.39, −0.27). Response surfaces revealed that lower proportional energy from protein, diluted by high fat and/or carbohydrate, was associated with higher total energy intake and greater 12-month increases in body weight, WHtR, and HHtR, but not FMI. Consumption of discretionary food, not other food sources, increased energy intake by reducing proportional energy from protein.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Maintaining dietary proportional energy from protein, particularly by limiting discretionary food consumption, was associated with reduced energy intake and improved WLM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"33 10","pages":"1995-2004"},"PeriodicalIF":4.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.24370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801332","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}