Obesity Reviews最新文献

{"title":"Empowerment in Obesity and Behavioral Weight-Management Programmes: A Scoping Review","authors":"Corinne Bolland,&nbsp;Anna Robins,&nbsp;Phillip Gray,&nbsp;Paul Sindall","doi":"10.1111/obr.70141","DOIUrl":"10.1111/obr.70141","url":null,"abstract":"<p>In the UK, over 25% of adults are living with obesity, with disproportionately higher rates among Black adults (35%) and those in the most deprived areas (36%). Obesity is linked to increased comorbidity, mortality, stigma, and substantial annual health costs exceeding £11.4 billion. Behavioral weight-management programmes are the primary intervention recommended for obesity treatment, yet they demonstrate limited effectiveness, inadequate long-term support, a lack of personalized care and poor cultural relevance. Participatory approaches, that is, bottom-up strategies engaging communities, are increasingly applied in public health to address social determinants and reduce disparities. Individuals supported to manage their health and access care are considered “empowered”; however, this concept remains ambiguous, lacking clear definition and consistent application. Although global policy promotes empowerment to promote individual health, including weight-management, no review has explored its role within obesity and weight-management programmes. This scoping review examined how empowerment has been defined and implemented across behavioral weight-management programmes. Eleven studies were identified published between 2004 and 2023, revealing poor consensus in their theoretical foundations, definitions, and practical applications of empowerment, with no UK-based studies. To support conceptual clarity, studies definitions and empowerment-based processes were consolidated. Further research is needed in UK settings to help define empowerment in this context and to enable effective translation between research, practice, and policy.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758435","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":"Beyond Sarcopenia: A Systematic Review and Meta-Analysis on Muscle Outcomes After Bariatric Surgery","authors":"Gabriël Eksteen,&nbsp;Lore Dubois,&nbsp;Bart Van der Schueren,&nbsp;Tim Vanuytsel,&nbsp;Christophe Matthys","doi":"10.1111/obr.70142","DOIUrl":"10.1111/obr.70142","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metabolic and bariatric surgery (MBS) produces substantial and sustained weight loss, but concerns remain about skeletal muscle loss and sarcopenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review of longitudinal and cross-sectional studies evaluating changes in muscle quantity, strength, and physical performance following MBS without interventions to preserve muscle. Searches were performed in PubMed, EMBASE, CINAHL, Web of Science, and Cochrane Central, and the review was registered with PROSPERO (CRD42022354153). Study quality was assessed using the Evidence Project Risk of Bias Tool. Meta-analyses were performed using standardized mean differences (SMDs) with random-effects models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-six reports from 64 studies were included, covering diverse surgical procedures and populations. Absolute muscle quantity declined at all timepoints, increasing over time (1-year SMD −0.80 [95% CI −0.97 to −0.63]), while relative muscle mass generally increased. Greater total weight loss predicted larger absolute muscle losses. Cross-sectional comparisons with non-surgical controls showed no consistent differences, although heterogeneity was high. Lower-body functional strength (e.g., chair stand) typically improved, while absolute arm and leg strength modestly declined or remained stable. Physical performance outcomes generally improved, suggesting preserved or enhanced functional capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Muscle loss after MBS appears largely adaptive, proportional to weight loss, and does not consistently impair functional capacity. Absolute and relative changes should be interpreted in the context of overall weight reduction. Adoption of standardized outcome measures and obesity-specific normative data for muscle quantity and function is needed to improve the early detection of sarcopenia and to distinguish adaptive muscle loss from clinically meaningful impairments after MBS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758268","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":"Toward \"Obesityomics\": Domain-Specific Omics in Precision Obesity Medicine with a Brief AI Perspective.","authors":"Nadia Abu Samra, Sara G I Suliman, Mohammed Al-Hadad, Dorret I Boomsma, Fadwa Alhantoobi, Maithah Alsamahi, Haneen Abufarajallah, Alia Al Tikriti, Zeyar Aung, Selena Richards, Abdulrahim Sajini, Mira Mousa, Fatima Sulaiman, Wael Osman","doi":"10.1111/obr.70226","DOIUrl":"https://doi.org/10.1111/obr.70226","url":null,"abstract":"<p><strong>Background: </strong>Obesity's global rise has outpaced the effectiveness of \"one-size-fits-all\" prevention and treatment strategies. The promise of precision medicine lies in addressing the etiological and biological diversity of obesity and transforming it into actionable endotypes.</p><p><strong>Objectives: </strong>In a narrative review, we analyze \"obesityomics,\" looking at the contributions each omics layer makes to understanding and managing obesity. The areas we evaluate are genomics (heritability, polygenic risk, and monogenic forms), epigenomics (development and environment imprinting), transcriptomics (tissue-specific programs of adipose, liver, muscle, and hypothalamus), proteomics (signaling networks and adipokines), metabolomics and lipidomics (fuel partitioning, lipotoxicity, and metabolic inflection points), and microbiome science (metabolites, host-microbe interactions, and microbial ecology). Our domain-by-domain (single-omics) approach demonstrates how disease taxonomy, causal pathways, and biomarkers can be refined and targeted therapeutically.</p><p><strong>Discussion: </strong>We argue that \"obesityomics\" is a pragmatic approach to aligning omics modalities to the right questions at the right time, not a wholesale merger of datasets. Artificial intelligence (AI)-including machine learning and deep learning-should be used in conjunction with quality control, feature selection, modest data integration, and obesity intervention prediction. Among the key challenges in managing sensitive multilayer data are harmonization, standardization, reproducibility, equitable representation, and governance. The translation priorities include prospective studies related to patient-centered outcomes, biomarker panels that are clinic-ready, interoperability standards, and cost-effectiveness evaluations.</p><p><strong>Conclusion: </strong>The review maps concrete steps to assist people with obesity in making better choices by identifying what each omics domain excels at and introducing a brief AI perspective.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70226"},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163564","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":"The Acute Effects of Interrupting Prolonged Sitting With Regular Activity Breaks on Postprandial Glucose and Insulin in Adults: A Systematic Review and Meta-Analysis","authors":"Jennifer T. Gale,&nbsp;Hannah Martin,&nbsp;Jillian J. Haszard,&nbsp;Meredith C. Peddie","doi":"10.1111/obr.70152","DOIUrl":"10.1111/obr.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Regular activity breaks improve postprandial glycemia, but the effects across different population groups and modes of breaks remain unclear. This systematic review and meta-analysis examined the impact of activity breaks on postprandial glucose and insulin response in adult populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies were identified from five databases until October 9, 2024. Eligible studies were acute (&lt; 24-h duration) laboratory-based randomized crossover trials comparing postprandial glucose and/or insulin response between prolonged sitting and activity breaks (&lt; 10 min, ≥ 3 breaks over 3 h). Risk of bias was assessed using the Downs and Black quality assessment tool. Random-effects meta-analysis was conducted including subgroup analyses by activity mode, frequency, and participant health/weight status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall 53 studies met the eligibility criteria; 39 were included in the meta-analysis. Compared with prolonged sitting, activity breaks lowered postprandial glucose incremental area under the curve (iAUC) (SMD −0.30, 95% CI −0.43 to −0.13) and insulin iAUC (SMD −0.30, 95% CI −0.46 to −0.14). Walking breaks had the greatest effect on glucose iAUC (SMD −0.33, 95% CI −0.48 to −0.17) and insulin iAUC (SMD −0.44, 95% CI −0.62 to −0.27), compared with other modes. Interrupting sitting every 15–20 min produced the largest reductions in glucose (SMD −0.51, 95% CI −0.83 to −0.19) and insulin iAUC (SMD −0.41, 95% CI −0.77 to −0.06). The largest reduction in glucose iAUC was observed in those living with obesity (SMD −0.52, 95% CI −1.07 to 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Frequent short walking breaks, performed every 20 min, provide the most improvement in postprandial glucose and insulin response in adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70152","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147809009","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":"Low Weight Loss Response to Incretin Analogs: A Systematic Review","authors":"Pamela S. Gaskin,&nbsp;Peter S. Chami","doi":"10.1111/obr.70145","DOIUrl":"10.1111/obr.70145","url":null,"abstract":"<p>The development of GLP-1 and GIP analogs has been a significant breakthrough in type 2 diabetes and obesity pharmacotherapy. However, individual responses to these medications can vary widely. This systematic review examines factors associated with low or no weight loss response to GLP-1 and GIP analogs. Key predictors of poor response include higher baseline body weight, BMI, HbA1c, and insulin resistance. Genetic factors, such as variants in the GLP1R gene, may also influence treatment outcomes. Metabolic health status, particularly glycemic control and insulin sensitivity, plays a crucial role in determining weight loss efficacy. Adherence to medication regimens is strongly associated with treatment success, with each additional month of treatment linked to greater weight loss. Lifestyle factors, including dietary habits and physical activity, can modulate responses to these medications. Emerging evidence suggests that gut microbiome composition may mediate weight loss outcomes. Demographic factors such as male sex and older age are associated with lower weight loss responses. Understanding these predictors is essential for optimizing treatment strategies, setting realistic expectations, and moving towards a precision medicine approach in obesity care. Further research is needed to validate these findings in diverse populations and develop practical tools for clinical decision-making.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830794","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":"Maternal Overnutrition in Pregnancy Predicts Greater Body Mass Index Gains in Offspring by Early Midlife: A Systematic Review and Meta-Analysis","authors":"Szimonetta Eitmann,&nbsp;Péter Mátrai,&nbsp;Péter Hegyi,&nbsp;Márta Balaskó,&nbsp;Erika Pétervári","doi":"10.1111/obr.70149","DOIUrl":"10.1111/obr.70149","url":null,"abstract":"<p>Maternal overnutrition during pregnancy predisposes children to increased adiposity later in life. This systematic review and meta-analysis examined how this association persists into adulthood and whether it differs by sex. MEDLINE, EMBASE, Scopus, and CENTRAL were searched for human studies published in English before May 2025. From 9191 screened records, 29 studies (430,764 mother–offspring pairs) provided quantitative data on the link between maternal pre-pregnancy body mass index (ppBMI) or gestational weight gain (GWG) and adiposity in adult offspring. The meta-analysis found significant positive associations between maternal ppBMI and offspring BMI, body fat percentage, or waist circumference. Each 1 kg/m² increase in maternal ppBMI was linked to a 0.4 kg/m² higher BMI and 0.35% more body fat in offspring. Maternal overweight/obesity predicted significantly higher offspring BMI or waist circumference, especially in females. Excessive GWG increased the odds of overweight/obesity in the offspring by 35% compared with adequate GWG. This correlation was stronger in early midlife (mean age 30–45) than in young adults. In early midlife offspring, each additional kilogram of GWG was linked to a 0.14 kg/m² higher BMI, independent of ppBMI. These findings underscore the importance of nutritional interventions before and during pregnancy to reduce obesity risk in adulthood.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831027","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":"The Impact of Front-of-Pack Labeling on Social Inequality in Sugar Consumption and Purchase: A Systematic Review","authors":"Ziyao Ge,&nbsp;Claudia H. Marck,&nbsp;Adyya Gupta,&nbsp;Gagandeep Kaur,&nbsp;Roisin McGrath,&nbsp;Ankur Singh","doi":"10.1111/obr.70150","DOIUrl":"10.1111/obr.70150","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review examined the impact of front-of-pack labeling (FOPL) on social inequality in sugar consumption and purchase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched Ovid MEDLINE, Scopus, EMBASE, and Web of Science for studies published in English since 2005. Eligible studies included randomized controlled trials and observational studies. The screening was conducted independently by at least two reviewers. Data extraction and quality assessments were cross-checked. The risk of bias was assessed using ROBINS-E, RoB2, and CHEERS 2022. A narrative synthesis summarized the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the total of 7701 studies identified, 10 studies were included. All included studies were conducted in high- and upper-middle-income countries, and primarily evaluated one specific type of FOPL, specifically warning labels (<i>n</i> = 8). All studies reported FOPL reduced sugar consumption at the population level. However, findings on social inequality were inconsistent. Five studies showed greater benefit among higher-socioeconomic groups, four among lower-socioeconomic groups, two identified a U-shaped effect, and two found no differential effect by socioeconomic status. The overall quality of studies was poor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>FOPL, in particular warning labels, can reduce sugar consumption, but its effects on socioeconomic inequalities were inconsistent. Evaluation of high-quality longitudinal research is needed to ensure FOPL interventions are inclusive and effective across socioeconomic groups.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969029","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 10-Year Update: Bibliometric Analysis of the Top 100 Papers in Metabolic and Bariatric Surgery","authors":"Florina Corpodean,&nbsp;Michael Kachmar,&nbsp;Iryna Popiv,&nbsp;Sammy Saqer,&nbsp;John Lovelace,&nbsp;Devan Lenhart,&nbsp;Michael Cook,&nbsp;Ali Aminian,&nbsp;Ricardo V. Cohen,&nbsp;Vance L. Albaugh,&nbsp;Philip R. Schauer","doi":"10.1111/obr.70146","DOIUrl":"10.1111/obr.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>As the field of metabolic surgery (MS), also known as bariatric surgery, continues to grow and change, especially in light of emerging anti-obesity medications, the need to identify seminal studies within this domain becomes increasingly crucial. This study aims to provide a comprehensive 10-year update on the most frequently cited articles in MS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Utilizing the SCOPUS database, we identified the top 100 most cited articles in MS as of July 2023. Beyond assessing the most frequently cited works, this study also examines articles with the most citations per year and explores the citation trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average number of citations per article increased from 383.5 in 2014 to 889.5. Forty-four papers from the original top 50 list in 2014 were included in the current list. The year 2004 had the most number in the top 100 (<i>n</i> = 10). While Roux-en-Y gastric bypass (RYGB) had the highest representation (48%), sleeve gastrectomy (SG) has rapidly risen in interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As the landscape of MS expands, the reassessment of top-cited scientific articles becomes imperative for obesity physicians and scientists, metabolic surgeons, fellows, and residents. Many of the articles listed in 2014 persisted in the 10-year update, reflecting the significant growth observed in the MS field during the early 2000s. The increased citation count likely indicates the expanding influence of MS research. Despite RYGB maintaining its status as the most studied procedure, a noticeable uptick in interest in sleeve gastrectomy post-2009 is evident as demonstrated by its increased representation within highly cited publications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985775","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":"The Effect of Behavioral Sleep Interventions on Measures of Obesity, Dietary Intake and Physical Activity in Adults With Poor Sleep Health: A Systematic Review, Meta-Analysis and Meta-Regression Analysis","authors":"Samiul A. Mostafa,&nbsp;Pushpa Singh,&nbsp;Feaz Babwah,&nbsp;Wasim Hanif,&nbsp;George Balanos,&nbsp;Krishnarajah Nirantharakumar,&nbsp;Jason G. Ellis,&nbsp;Abd A. Tahrani","doi":"10.1111/obr.70139","DOIUrl":"10.1111/obr.70139","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;As poor sleep negatively impacts on adiposity, there is interest in examining whether improving sleep can improve adiposity markers. We reviewed studies aimed at improving sleep using (1) cognitive behavioral therapy for insomnia (CBT-I) and/or sleep hygiene and (2) sleep extension on adiposity markers, dietary intake, and physical activity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Literature searches were performed on MEDLINE, Embase, CINAHL, and Cochrane Library. We included studies featuring adults ≥ 18 years without OSA, a sleep intervention as well as preintervention and postintervention measures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;From a total of 27 studies, 25 were used in the meta-analyses. Using CBT-I and/or sleep hygiene in eight studies (&lt;i&gt;n&lt;/i&gt; = 1384) led to significant BMI reductions averaging 0.64 kg/m&lt;sup&gt;2&lt;/sup&gt; (0.28, 1.01, &lt;i&gt;p&lt;/i&gt; = 0.0006, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 16%) but the reductions were not significant in five studies (&lt;i&gt;n&lt;/i&gt; = 138) of sleep extension, 0.15 kg/m&lt;sup&gt;2&lt;/sup&gt; (−0.40, 0.11, &lt;i&gt;p&lt;/i&gt; = 0.26). In obesity (&lt;i&gt;n&lt;/i&gt; = 78, 3 studies) and in type 2 diabetes (&lt;i&gt;n&lt;/i&gt; = 1121, 3 studies) BMI reductions averaged 1.53 (0.49, 2.56, &lt;i&gt;p&lt;/i&gt; = 0.004, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%) and 0.64 kg/m&lt;sup&gt;2&lt;/sup&gt; (0.37, 0.92, &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%), respectively. For body weight, using sleep interventions led to significant reductions in the obese (&lt;i&gt;n&lt;/i&gt; = 72, 3 studies) and overweight ranges (&lt;i&gt;n&lt;/i&gt; = 337, 6 studies), averaging 5.55 (4.13, 6.97, &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%) and 0.83 kg (0.32, 1.35, &lt;i&gt;p&lt;/i&gt; = 0.002, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%), respectively. Using sleep interventions reduced daily energy intake (&lt;i&gt;n&lt;/i&gt; = 223, 5 studies) by 147.5 cal/day (5.74, 289.41, &lt;i&gt;p&lt;/i&gt; = 0.04, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 53%), but was higher in the obese/overweight range (&lt;i&gt;n&lt;/i&gt; = 122, 3 studies) at 238.0 cal/day (138.86, 337.22, &lt;i&gt;p&lt;/i&gt; &lt; 0.00001, &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 0%); sugar consumption reduced (&lt;i&gt;p&lt;/i&gt; = 0.05), and protein consumption increased (&lt;i&gt;p&lt;/i&gt; = 0.001). There were no changes in physical activity or sedentary behavior levels. On quality assessment, 12 and 10 studies were of low and some concerns, respectively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Addressing poor sleep health through using sleep interventions has the potential to be integrated into obesity management programs, alongside current lifestyle strategies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 ","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758389","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":"GLP-1 Receptor Agonists and Weight Loss: A Critical Review of Mechanisms","authors":"Giorgia Rutigliani,&nbsp;Tzu-Wen L. Cross,&nbsp;Erica de Jong,&nbsp;Emily S. Glover,&nbsp;Ivan D. Mendoza,&nbsp;Mojisola Adisa,&nbsp;Keigo Tomoo,&nbsp;Xinyi Zhou,&nbsp;Richard D. Mattes","doi":"10.1111/obr.70148","DOIUrl":"10.1111/obr.70148","url":null,"abstract":"<p>GLP-1 receptor agonist medications have the potential to promote marked weight loss, but maximal and sustained benefit may be compromised by poor compliance and cessation of use. Development of next-generation medications that address current obstacles to effective use and development of effective adjunct treatments will benefit from better characterization of their mechanisms of action. This narrative review critically assesses eight purported mechanisms including modulation of appetite, chemosensory function, cravings/aversions, food noise, gastric emptying, the microbiome, incretin activity, and energy expenditure. Current evidence does not support a single dominant mechanism; a combination of subtle effects may underlie the efficacy of these medications. However, as experience with these medications and methods to assess their effects grows, it should be possible to better determine the relative importance of these and possibly other mechanisms.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 11","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147830838","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}