Obesity最新文献

{"title":"BODY-Q-7D Measures Consensus-Based Patient-Reported Outcomes for the Management of Obesity Treatment","authors":"Anne F. Klassen,&nbsp;Charlene Rae,&nbsp;Claire E. E. de Vries,&nbsp;Farima Dalaei,&nbsp;Manraj N. Kaur,&nbsp;Lucas Gallo,&nbsp;Maarten Hoogbergen,&nbsp;Lotte Poulsen,&nbsp;Andrea L. Pusic,&nbsp;Stefan J. Cano","doi":"10.1002/oby.70254","DOIUrl":"10.1002/oby.70254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>A global multidisciplinary consensus initiative identified eight patient-reported outcome domains important in obesity care: self-esteem; physical, mental, and social health; eating; stigma; body image; and excess skin. Several of these domains are not represented in generic preference-based measures typically used in weight loss research. We developed the BODY-Q-7 Dimensions (BODY-Q-7D) to provide a valuation-ready framework for a preference-based instrument.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Concepts from the BODY-Q were used to inform the development of items that covered the eight consensus initiative domains. Psychometric performance of the BODY-Q-7D was examined using an online international sample (i.e., Prolific).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Content validity was established with 123 participants. The field test included 770 participants, of whom 269 completed a test–retest, and 599 completed a 3-month follow-up. Rasch Measurement Theory analysis reduced the BODY-Q-7D to 7 items. Items fit the Rasch model with ordered thresholds and structural independence. Reliability was &gt; 0.80 across three reliability coefficients. Hypothesis-based tests of construct validity and responsiveness were supported with 22/28 (79%) and 12/16 (75%) tests accepted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The BODY-Q-7D demonstrated strong psychometric performance in a weight loss sample. The next phase of development is to elicit and model preference weights to assign utility values to each defined health state.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1600-1612"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581860","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":"Increasing Obesity Severity Is Associated With Less Surgical Care in the United States","authors":"Michael Kachmar,&nbsp;Florina Corpodean,&nbsp;Hector J. Garcia Navas,&nbsp;Molly Perkins,&nbsp;Carlos Galvani,&nbsp;Michael W. Cook,&nbsp;Denise M. Danos,&nbsp;David A. Hughes,&nbsp;Philip R. Schauer,&nbsp;Vance L. Albaugh","doi":"10.1002/oby.70240","DOIUrl":"10.1002/oby.70240","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Approximately 41% of the US population has obesity, though the prevalence of the highest BMI populations (e.g., ≥ 60 kg/m²) is increasing most rapidly. Given the association between obesity and surgical disease burden, we hypothesized that higher BMI groups would account for a growing proportion of operative volume over time. This study examined whether individuals with higher BMI have been receiving proportionally more surgical care over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All multispecialty National Surgical Quality Improvement Program (NSQIP) cases from 2005 to 2022 were analyzed (<i>n</i> = 11,634,075). Multinomial logistic regression was performed to analyze trends among BMI categories (&lt; 30.0, 30.0–39.9, 40.0–49.9, 50.0–59.9, 60.0–69.9, and ≥ 70 kg/m²), while adjusting for demographics and comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regression models demonstrated decreased odds of patients with BMI ≥ 50 kg/m² undergoing surgery over consecutive years, with increasingly higher BMI groups representing greater declines. Patients with BMI 30.0–39.9 kg/m² demonstrated increased proportional operative volume.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite increased growth in higher BMI populations, individuals in these categories undergo fewer surgical operations annually. These findings demonstrate a critical need to understand these inequalities, which are underscored by rising obesity prevalence that may be contributing to poor access to surgical care as well as increased morbidity/mortality of presentation with more advanced disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1647-1654"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207386","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":"Response to: “Revisiting Motivation in Pediatric Weight Management: A Self-Determination Perspective on the STARKIDS Cohort Findings”","authors":"Katrin Ziser,&nbsp;Anne Herschbach,&nbsp;Rebecca Erschens,&nbsp;Stefan Ehehalt,&nbsp;Stephan Zipfel,&nbsp;Katrin Giel,&nbsp;Florian Junne","doi":"10.1002/oby.70245","DOIUrl":"10.1002/oby.70245","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1529-1530"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221246","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":"Six- and Twelve-Month Changes in Body Composition and 24-h Energy Expenditure After a Very Low-Calorie Ketogenic Diet","authors":"Alessio Basolo,&nbsp;Paolo Piaggi,&nbsp;Valentina Angeli,&nbsp;Paola Fierabracci,&nbsp;Chiara Bologna,&nbsp;Giordano Paolucci,&nbsp;Guido Salvetti,&nbsp;Luca Chiovato,&nbsp;Jonathan Krakoff,&nbsp;Alberto Landi,&nbsp;Ferruccio Santini","doi":"10.1002/oby.70236","DOIUrl":"10.1002/oby.70236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study assessed changes in body composition and 24-h energy metabolism at 6 and 12 months after initiation of a 1-month very low-calorie ketogenic diet (VLCKD) in women with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventeen women with obesity who completed a 1-month VLCKD underwent a 4-week transition phase with carbohydrate reintroduction, followed by a hypocaloric balanced diet. Assessments of body composition by dual-energy X-ray absorptiometry (DXA) and 24-h energy expenditure (24hEE) by a whole-room indirect calorimeter were performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following the initial 7% weight loss, body weight further decreased at 6 months (−3.9%, <i>p</i> &lt; 0.05), primarily driven by a significant decrease in fat mass (−10%, <i>p</i> &lt; 0.05). From 6 to 12 months, three participants continued to lose weight, whereas most remained stable or partially regained. Lean soft tissue, decreased during the VLCKD phase, remained stable throughout follow-up. Both 24hEE and 24-h sleeping metabolic rate exhibited a progressive trend toward increase. Minute-by-minute 24hEE trajectories revealed a significant increase in metabolic rate from 1 to 6 months (<i>p</i> &lt; 0.001). The metabolic adaptation observed after 1 month of VLCKD was no longer detectable at either 6 or 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide novel insight into the physiological adaptations following VLCKD, supporting its role in supervised weight loss programs for selected patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT07418281</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1558-1568"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261093","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-Related Self-Esteem, Group Behavioral Therapy, and Weight Loss","authors":"Joshua Bernal,&nbsp;Jo A. Wick,&nbsp;Byron Gajewski,&nbsp;K. Allen Greiner,&nbsp;Jianzheng Wu,&nbsp;Christie Befort","doi":"10.1002/oby.70257","DOIUrl":"10.1002/oby.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Patients with obesity report experiencing weight stigma resulting in poor self-esteem. Based on baseline self-esteem, this paper explores recommendations for group versus individual visits for lifestyle components of comprehensive obesity treatment in primary care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants (<i>n</i> = 1220) were rural primary care patients in a 24-month cluster randomized controlled trial that demonstrated superior weight loss with group versus individual treatment. Baseline weight-related self-esteem scores (0–100), as measured by the Impact of Weight on Quality of Life-Lite (IWQOL-L), were used. A Bayesian normal dynamic linear model with a changepoint parameter estimates the relationship between self-esteem and weight loss across group versus individual treatment at the 24-month primary endpoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The posterior probability that patients receiving <i>group</i> lost more weight than those receiving <i>individual</i> visits remained <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 \u0000 <mrow>\u0000 \u0000 <mo>&gt;</mo>\u0000 </mrow>\u0000 </mrow>\u0000 <annotation>$$ &gt; $$</annotation>\u0000 </semantics></math> 0.999 for patients with self-esteem scores greater than 60. Those with the highest self-esteem (scores 80–100) receiving <i>group</i> visits lost 6.7 kg (95% CI, −8.15 to −5.20) at 24 months compared to 3.9 kg (95% CI, −5.45 to −2.39) for those receiving <i>individual</i> visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>People may benefit more from <i>group</i> than <i>individual</i> intervention if their self-esteem is above an IWQOL-L score of 60 when starting an intensive behavioral intervention for weight loss.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT02456636.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 8","pages":"1541-1544"},"PeriodicalIF":4.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13353204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414522","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":"Food Addiction Risk Accelerates Fat Accumulation in Youth: Potential Protective Roles of Left Insula and Mindful Eating","authors":"Dan Wang,&nbsp;Ke Huang,&nbsp;Xuelian Zhou,&nbsp;Xian Ye,&nbsp;Junqing Chen,&nbsp;Hongzhen Xu,&nbsp;Guanping Dong,&nbsp;Ting Yuan,&nbsp;Xiaochun Chen,&nbsp;Hui Zhou,&nbsp;Marc N. Potenza,&nbsp;Junfen Fu","doi":"10.1002/oby.70225","DOIUrl":"10.1002/oby.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Food addiction (FA) is implicated in obesity, yet the potential moderating role of mindful eating and the underlying neural mechanisms in youth remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study integrated a multicenter cross-sectional survey, a longitudinal study with 6- and 12-month follow-ups, and an independent magnetic resonance imaging (MRI) sample. FA, eating motives, mindful eating, BMI <i>z</i>-score, fat content, and visceral fat level were assessed. Analyses utilized structural equation modeling, latent growth modeling, and voxel-based morphometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2071 screened, 1601 youth (55.5% boys; mean age = 12.69 ± 3.04 years) completed the baseline survey, with 880 and 564 completing the 6- and 12-month follow-ups, respectively. FA mediated the relationship between eating motives and weight status, and mindful eating moderated this pathway (<i>p</i> &lt; 0.05). Longitudinally, baseline FA predicted accelerated accumulation of fat content and visceral fat level, but not BMI <i>z</i>-score (<i>p</i> &gt; 0.05). The independent 75-MRI sample revealed that left insula gray-matter volume was negatively associated with FA but positively associated with mindful eating.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FA may link eating motives to fat accumulation in youth, particularly abdominal fat; mindful eating may be protective, with left insula structure and left insula-striatum connectivity as possible neural correlates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 7","pages":"1433-1445"},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148140681","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":"Prevalence of Pre-Clinical Obesity Among US Adults Receiving Medical and Surgical Obesity Treatment","authors":"Jason M. Samuels,&nbsp;Emma Holler,&nbsp;Matthew D. Spann,&nbsp;C. Joe Northup,&nbsp;Tarik K. Yuce","doi":"10.1002/oby.70171","DOIUrl":"10.1002/oby.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We sought to determine how the proportion of adults historically receiving obesity interventions would be classified under the recently proposed “pre-clinical” and “clinical” obesity classifications and the impact of this change on safety and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of adults with BMI ≥ 35 who received bariatric surgery (BS) or antiobesity medications (AOMs) between 2017 and 2023 was conducted using the Merative MarketScan database. Patients had ≥ 6-month continuous enrollment before treatment. Clinical obesity was defined as presence of ≥ 1 obesity-related condition and pre-clinical obesity defined as absence of such. Treatment-related complications were identified within 90 days of treatment initiation. Multivariable logistic regression was used to compare the odds of treatment-related complications by obesity classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 120,499 individuals (46.1%) underwent BS and 140,909 (53.9%) received AOMs. Among BS patients, 12.7% (<i>n</i> = 15,334) had pre-clinical obesity. Of AOM users, 38.1% (<i>n</i> = 53,633) had pre-clinical obesity. Clinical obesity patients were older with a higher comorbidity burden compared to pre-clinical obesity. Clinical obesity was associated with higher odds of post-treatment complications (AOM: aOR 1.10, BS: aOR 1.39, both <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This novel framework would reclassify a significant proportion of patients as having pre-clinical obesity. Use of these definitions to determine treatment eligibility could potentially delay intervention and shift care to older, sicker populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 7","pages":"1493-1501"},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147978372","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":"Bariatric Surgery in Adolescents With Obesity: Weight and Cardiometabolic Outcomes—Real-World Data","authors":"Shlomit Shalitin,&nbsp;Moshe Phillip,&nbsp;Michal Yackobovitch-Gavan","doi":"10.1002/oby.70227","DOIUrl":"10.1002/oby.70227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated changes in weight status and cardiometabolic parameters following bariatric surgery (BS) among adolescents with obesity using population-based real-world data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study used electronic health records from Clalit Health Services, Israel. Adolescents aged 12–20 years who underwent BS between 2010 and 2024 were included. Demographic characteristics, socioeconomic position (SEP), anthropometry, blood pressure, and laboratory parameters were extracted. Longitudinal changes in BMI and cardiometabolic outcomes were analyzed using mixed-effects models adjusted for sex, ethnicity, SEP, age at BS, and baseline BMI. Median follow-up was 5.8 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort included 1035 adolescents (69.7% female; median age at surgery ~18.6 years), with sleeve gastrectomy as the predominant procedure. BMI declined significantly over time (<i>p</i>\u0000 _{\u0000 <i>time</i>\u0000} &lt; 0.001), with maximal reduction at 1–3 years and sustained improvement thereafter. Males experienced greater BMI reduction than females (<i>p</i>\u0000 _{\u0000 <i>time</i>×sex} &lt; 0.001). BMI trajectories were similar across SEP and ethnic groups, while individuals with higher baseline BMI maintained higher BMI throughout follow-up (<i>p</i>\u0000 _{\u0000 <i>group</i>\u0000} &lt; 0.001). Blood pressure and multiple metabolic parameters improved substantially, with durable long-term benefits and some sex-specific differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Adolescent BS was associated with sustained improvements in BMI and cardiometabolic risk factors in a large real-world cohort, supporting its long-term effectiveness across population subgroups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 7","pages":"1477-1492"},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.70227","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177430","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":"Using the Lancet Guideline to Ration Obesity Care—Real or Imagined?","authors":"Adam H Gilden,&nbsp;Barbara McGowan","doi":"10.1002/oby.70238","DOIUrl":"10.1002/oby.70238","url":null,"abstract":"","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 7","pages":"1365-1366"},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019846","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":"Effect of Sevelamer and B. longum on Insulin Sensitivity in Participants With Obesity: A Randomized Clinical Trial","authors":"Eric Baeuerle,&nbsp;Manpreet K. Semwal,&nbsp;Jia Nie,&nbsp;Ning Zhang,&nbsp;Hanyu Liang,&nbsp;Vinutha Ganapathy,&nbsp;Nattapol Sathavarodom,&nbsp;Roman Fernandez,&nbsp;Chen-Pin Wang,&nbsp;Sara Espinoza,&nbsp;Qunfeng Dong,&nbsp;Xiang Gao,&nbsp;Zhen Yang,&nbsp;Aleksandar Kostic,&nbsp;Nicolas Musi","doi":"10.1002/oby.70224","DOIUrl":"10.1002/oby.70224","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated whether two interventions with putative lipopolysaccharide (LPS)-lowering properties, the phosphate binder sevelamer or a synbiotic, improve insulin sensitivity in humans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a randomized, double-blind, placebo-controlled, three-arm parallel-group trial. Twenty-two lean and twenty-eight participants with obesity completed the trial. Participants were randomized to: (1) sevelamer; (2) synbiotic (oligofructose plus \u0000 <i>Bifidobacterium longum</i>\u0000 Rosell-175); or (3) placebo, three times a day for 4 weeks. The primary outcome was change in peripheral insulin sensitivity (M) assessed by hyperinsulinemic (60 mU/m² min) euglycemic clamp versus placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In participants with obesity, sevelamer improved the M (+2.176 [0.314, 4.038] mg/kg min vs. placebo; <i>p</i> = 0.022) and lowered LDL-C (−29.675 [−53.794, −5.556] mg/dL vs. placebo; <i>p</i> = 0.016). Synbiotic had no effect on insulin sensitivity or lipids in either group. No changes in markers of endotoxemia were observed with any intervention. Sevelamer increased plasma levels of metabolites linked to improved glucose and lipid metabolism, such as bile acids, amino acids (citrulline, betaine), NAD+ precursors (trigonelline), and xenobiotics (genistein, umbelliferone).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Sevelamer improves insulin sensitivity and LDL-C in participants with obesity. Further investigation is warranted to elucidate sevelamer's metabolic mechanisms, potentially involving the mediation of bile acids and other host-microbiome-derived metabolites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicialTrials.gov NCT02127125</p>\u0000 </section>\u0000 </div>","PeriodicalId":215,"journal":{"name":"Obesity","volume":"34 7","pages":"1382-1394"},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950600","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}