Obesity最新文献

{"title":"Association of Glucagon-Like Peptide-1 Receptor Agonists With Cancer Risk in Older Adults With Type 2 Diabetes","authors":"Ying Lu,&nbsp;Hao Dai,&nbsp;Huilin Tang,&nbsp;William T. Donahoo,&nbsp;Thomas J. George,&nbsp;Ramon C. Sun,&nbsp;Sizun Jiang,&nbsp;Aik Choon Tan,&nbsp;Yi Guo,&nbsp;Jonathan D. Licht,&nbsp;John M. Allen,&nbsp;Kelvin P. Lee,&nbsp;Jingchuan Guo,&nbsp;Jiang Bian","doi":"10.1002/oby.24366","DOIUrl":"10.1002/oby.24366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The real-world evidence on the association between glucagon-like peptide-1 receptor agonists (GLP-1RAs) and cancer risk remains limited and mixed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In 2013–2020 national Medicare claims data, we included cancer-naïve patients with type 2 diabetes (T2D). We identified those who initiated GLP-1 RA, sodium-glucose cotransporter 2 inhibitor (SGLT2i), or dipeptidyl peptidase 4 inhibitor (DPP4i) and conducted 1:1 propensity score matching for confounding adjustment. Cox proportional hazards models were used to estimate hazard ratios (HR) of nine obesity-associated cancers (thyroid, pancreatic, bladder, colorectal, lung, kidney, breast, endometrial, and prostate cancer).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the matched GLP-1RA versus SGLT2i cohort (<i>n</i> = 21,362 pairs), GLP-1RA users had similar overall cancer risk with SGLT2i users (HR, 1.03 [95% CI, 0.95–1.12]), but GLP-1RAs were associated with an increased kidney cancer risk (HR, 1.43 [1.06–1.92]). In the matched GLP-1RA versus DPP4i cohort (<i>n</i> = 20,962 pairs), the GLP-1RA versus DPP4i comparison showed no significant difference in overall cancer risk (HR, 0.96 [0.89–1.04]) but revealed a significantly elevated endometrial cancer risk (HR, 1.55 [1.01–2.37]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GLP-1RAs might be associated with an increased risk of certain cancer types. Future studies are needed to validate the potential tumorigenic risk associated with GLP1-RAs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 S2","pages":"75-87"},"PeriodicalIF":4.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12906048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984489","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":"Weight Loss, Obesity Medication, and Risk of Obesity-Associated Cancer: A Meta-Analysis of Randomized Controlled Trials","authors":"Chengwen Li,&nbsp;Chu Lin,&nbsp;Xiaoling Cai,&nbsp;Fang Lv,&nbsp;Wenjia Yang,&nbsp;Linong Ji","doi":"10.1002/oby.70054","DOIUrl":"10.1002/oby.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine whether weight reduction mediated by antiobesity medications (AOMs) contributes to the risk reduction in obesity-associated cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov website were systematically searched for randomized controlled trials of AOMs from inception to December 2024. Relative risks were calculated using a random-effects model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis included 25 randomized controlled trials with 40,731 participants. Compared with placebo, AOMs showed no association with the risk of overall obesity-related cancer (RR = 1.03, 95% CI: 0.78 to 1.37) or site-specific cancer. Consistently, every 5 kg weight reduction mediated by AOMs was not associated with the risk of overall obesity-related cancer (RR = 0.97, 95% CI: 0.84 to 1.12) or site-specific cancer. However, subgroup analysis revealed that coagonists (tirzepatide, cotadutide, and cagrilintide) significantly reduced overall obesity-associated cancer risk (RR = 0.43, 95% CI: 0.19 to 0.97), and every 5 kg weight reduction mediated by coagonists was marginally associated with a reduced overall obesity-associated cancer risk (RR = 0.79, 95% CI: 0.62 to 1.00).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Weight reduction mediated by current AOMs was not associated with a reduced risk of overall or site-specific obesity-associated cancer in patients with overweight or obesity, while a decreased risk of overall obesity-associated cancer was observed in coagonist users.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 S2","pages":"16-24"},"PeriodicalIF":4.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446995","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":"Wernicke's Encephalopathy Following Semaglutide Treatment for Obesity: A Systematic PRISMA Review of Case-Based Evidence","authors":"Janice Bidesie,&nbsp;Erik Oudman","doi":"10.1002/oby.70256","DOIUrl":"10.1002/oby.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Glucagon-like peptide-1 receptor agonists are increasingly prescribed for obesity. Although generally considered safe, marked appetite suppression and persistent gastrointestinal adverse effects may increase the risk of nutritional deficiencies. Wernicke's encephalopathy (WE), caused by thiamine deficiency, is a rare but potentially fatal neurological disorder that may result in irreversible cognitive impairment if not promptly recognized and treated. Recently, cases of WE associated with semaglutide use have been reported. This study aimed to systematically review published case reports of WE occurring after semaglutide treatment for obesity from an endocrinological drug safety perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic literature search was conducted in PubMed, Embase, CINAHL, and Scopus according to PRISMA guidelines. Case reports were included when semaglutide was prescribed for obesity and the presentation was consistent with WE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six cases were identified. All patients experienced prolonged gastrointestinal symptoms and substantial weight loss before neurological deterioration. Common manifestations included altered mental status and oculomotor abnormalities. Outcomes were poor in several cases, including progression to Korsakoff syndrome or death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinicians should remain vigilant for thiamine deficiency in patients with persistent gastrointestinal intolerance or rapid weight loss during GLP-1 treatment, as early parenteral thiamine administration is essential to prevent irreversible neurological sequelae.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 S2","pages":"64-69"},"PeriodicalIF":4.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70256","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383429","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":"Perceived Competence and GLP-1RA Weight Management Engagement: Mixed-Methods Insights From Six Patient Groups","authors":"Jane A. McElroy,&nbsp;Isabella Bertarelli,&nbsp;Chloe Maltagliati,&nbsp;Jamie Smith,&nbsp;Regina DePietro","doi":"10.1002/oby.70275","DOIUrl":"10.1002/oby.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore patients' perspectives on GLP-1 receptor agonists (GLP-1RAs) for weight loss across the continuum of contemplating use to discontinuation, with and without achieving weight loss goals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From June to October 2025, participants completed a 30-item survey and ~30-question semi-structured interview regarding their perceptions of GLP-1RAs for weight loss. Interviews were tailored to six GLP-1RA groups: (1) considering use; (2) &lt; 3 months on therapy; (3) ≥ 3 months on therapy without achieving weight loss goal; (4) ≥ 3 months on therapy with achieving weight loss goal; (5) discontinued without achieving goal; and (6) discontinued after achieving goal. Qualitative coding and thematic analysis were conducted in Dedoose (9.0.107); quantitative analyses used SAS 9.4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 185 participants consented, and 141 completed data collection (76%). Descriptive profiles suggested heterogeneity across psychosocial and behavioral domains. Groups 3 and 4 showed stronger profiles (higher perceived competence, intrinsic motivation, and self-monitoring). After false discovery rate adjustment across 78 comparisons, perceived competence was the only statistically significant differentiator: Group 1 was lower (<i>z</i> = −3.15; <i>q</i> = 0.0347) and Group 4 higher (<i>z</i> = 4.44; <i>q</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings underscore the importance of tailoring behavioral support to individuals' stage of engagement in GLP-1RA-supported weight loss journeys.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 9","pages":"1759-1771"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148703160","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":"Micro Doses, Macro Potential? Considerations for Microdosing Tirzepatide in Multi-Dose Pens","authors":"Abigail B. Lodrigues,&nbsp;Alissa V. Russell,&nbsp;Shelby Tungate Lopez,&nbsp;Anne M. Komé","doi":"10.1002/oby.70253","DOIUrl":"10.1002/oby.70253","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 9","pages":"1684-1686"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166298","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":"Personalized Weight-Loss Targets for Metabolic Syndrome Reversal: A BMI-Normalization Achievement Rate-Based Cohort Study","authors":"Junfeng Qi,&nbsp;Longzhu Xiong,&nbsp;Chuansha Wu,&nbsp;Xiaojie Sun,&nbsp;Junlin Li,&nbsp;Likun Ren,&nbsp;Chaoliang Yi,&nbsp;Yuqin Shi,&nbsp;Ling Zhang,&nbsp;Xiongfei Pan,&nbsp;Ting Zhou,&nbsp;Shuzhen Zhu","doi":"10.1002/oby.70269","DOIUrl":"10.1002/oby.70269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore personalized weight-loss targets for metabolic syndrome (MetS) reversal by introducing the BMI-normalization achievement rate (BMI-NAR), a novel baseline-BMI-scaled metric.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a longitudinal cohort of 7340 adults with overweight/obesity and MetS from the ChinaHEART project, BMI-NAR was defined as the percentage of progress toward a normal BMI (&lt; 24 kg/m²). Logistic regression and restricted cubic splines assessed the dose–response relationship between BMI-NAR and MetS reversal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Each 50% increase in BMI-NAR was significantly associated with MetS reversal (overall: OR = 1.10, 95% CI: 1.07–1.12; overweight: OR = 1.08, 95% CI: 1.06–1.11; obesity: OR = 2.36, 95% CI: 2.00–2.80). The probability of reversal increased steeply beyond exploratory minimum effective thresholds (37% BMI-NAR for overall; 53% for overweight; 22% for obesity), with benefits observed up to ~165% in the total population, beyond which data were sparse. No clear upper plateau was identified in populations with overweight and obesity. These exploratory thresholds translate into personalized weight-loss targets: a minimum reduction of 2%–8% for typical overweight (baseline BMI 25–27.99 kg/m²) and 3%–9% for obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MetS reversal does not require full BMI normalization. BMI-NAR provides a hypothesis-generating, quantifiable framework for exploring personalized minimum effective weight-loss goals in this high-risk population. However, external validation is required before clinical application.</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":"34 9","pages":"1718-1731"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649941","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":"Patient Characteristics and Engagement in CGM-Supported Virtual Weight Management","authors":"Chen Zheng,&nbsp;Jiage Niu,&nbsp;Yingying Xu","doi":"10.1002/oby.70258","DOIUrl":"10.1002/oby.70258","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 9","pages":"1682-1683"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671845","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":"From Guidelines to Clinical Practice: Expert Perspectives on Long-Term Management of Obesity","authors":"Hong Chen,&nbsp;Ling Li,&nbsp;Junqing Zhang,&nbsp;Shaihong Zhu,&nbsp;Marc-André Cornier,&nbsp;Jonathan Q Purnell","doi":"10.1002/oby.70263","DOIUrl":"https://doi.org/10.1002/oby.70263","url":null,"abstract":"<p>An international panel of experts from the U.S. and China convened to discuss the <i>2026</i> <i>TOS–OMA–OAC Expert Guidance Statement on the Pharmacological Management of Obesity,</i> focusing on emerging evidence, regional considerations, and challenges in translating recommendations into long-term care. Panelists reached a consensus that obesity should be recognized as a chronic and progressive disease, for which pharmacotherapy is lifelong once initiated, as discontinuation consistently leads to weight regain and loss of metabolic benefit. The discussion highlighted a shift toward treating obesity itself as an upstream intervention capable of modifying multiple obesity-related complications, with greater weight loss generally conferring greater clinical benefit. Visceral adipose tissue emerged as a particularly relevant therapeutic target, especially in Asian populations, where substantial metabolic risk may be present at lower BMI levels. Panelists noted heterogeneity in treatment response and that eventual weight-loss plateaus should be anticipated as evidence of maximal effectiveness rather than medication failure. The panel endorsed an individualized, stepwise approach integrating pharmacotherapy and metabolic surgery as complementary strategies. Finally, the panel emphasized that translating therapeutic advances into real-world benefit will require addressing practical barriers related to policy, access, affordability, and stigma to ensure effective care reaches those who need it most.</p>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 9","pages":"1708-1717"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70263","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816622","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":"A CVD Classification Model for Individuals With Obesity: Multi-Ethnic Validation Based on Multiple Metabolic Indicators","authors":"Runmin Cao,&nbsp;Yurun Zhang,&nbsp;Ling Cao,&nbsp;Honghe Jiang","doi":"10.1002/oby.70265","DOIUrl":"10.1002/oby.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The global rise in obesity, a major risk factor for cardiovascular disease (CVD), contributes substantially to the disease burden. We developed and validated a model optimized for classifying prevalent CVD in individuals with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the training cohort, risk factors were screened by univariate and LASSO regression and then incorporated into a multivariate logistic model to establish the classifier. Based on this model, a nomogram was constructed. The area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were used to evaluate model performance. Sensitivity was analyzed using a unified BMI standard in the Korea cohort. A web-based dynamic nomogram was also implemented (https://min115.shinyapps.io/CVDrisk/).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final nomogram incorporated age, hypertension, diabetes, metabolic score for visceral Fat (METS-VF), serum creatinine, and blood urea nitrogen. In internal validation, the model achieved an AUC of 0.799, with a Hosmer–Lemeshow <i>p</i> value of 0.823. In external validation, the AUC was 0.821, with a Hosmer–Lemeshow <i>p</i> value of 0.083. In both the internal and external validation sets, the model demonstrated good clinical utility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study developed and validated a nomogram for the classification of prevalent CVD in individuals with obesity, providing a validated model optimized for the population with obesity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 9","pages":"1806-1817"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551907","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":"Body Composition and Lifestyle Interventions in Pharmacological Treatment of Acquired Hypothalamic Obesity: A Systematic Review of Randomized Controlled Trials","authors":"Hanhan Yu,&nbsp;Jieping Wang,&nbsp;Mingyue Yin,&nbsp;Lili Ji,&nbsp;Shanshan Guo,&nbsp;Tiemin Liu,&nbsp;Ru Wang","doi":"10.1002/oby.70267","DOIUrl":"https://doi.org/10.1002/oby.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review aimed to systematically evaluate the effects of pharmacological interventions on body composition outcomes and lifestyle intervention as background therapy in patients with acquired hypothalamic obesity (aHO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Searches were conducted in PubMed, Embase, the Cochrane Library, CINAHL, and CNKI for studies published between July 24, 2015, and November 8, 2025. Eligible studies were full-text randomized controlled trials (RCTs) evaluating pharmacological and/or lifestyle weight management interventions in patients with aHO of any age. Outcomes included four domains: anthropometric and body composition measures, metabolic markers, behavioral and energy-related outcomes, and adverse events. Risk of bias was assessed using the adapted Cochrane Risk of Bias Tool, and certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Owing to substantial heterogeneity in interventions and outcome measurements, only descriptive synthesis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven RCTs were included. Semaglutide demonstrated sustained weight loss, while long-acting exenatide reduced fat mass without substantial lean mass loss. Tesomet was associated with reductions in both body weight and lean mass, whereas diazoxide showed limited efficacy for weight management. Several interventions improved satiety and reduced hunger, although metabolic findings were inconsistent across studies. Adverse events were mostly mild to moderate. Risk of bias assessment identified one study at high risk of bias and one with some concerns. According to the GRADE framework, certainty of evidence was low for anthropometric/body composition, metabolic, and behavioral/energy outcomes and moderate for adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Current evidence suggests that selected pharmacological interventions may improve weight-related and body composition outcomes in aHO; however, evidence remains limited and of predominantly low certainty. Existing studies are constrained by inadequate assessment of lean body mass and poorly standardized lifestyle interventions. Future large-scale, long-term RCTs incorporating systematic body composition assessment and structured lifestyle intervention protocols are needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 9","pages":"1687-1698"},"PeriodicalIF":4.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816623","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}