Obesity ReviewsPub Date : 2026-09-08Epub Date: 2026-04-19DOI: 10.1111/obr.70133
Gernot Desoye, Ursula Hiden, Evelyn Jantscher-Krenn, Herbert Fluhr, Jonathan C. Wells, Sonja Entringer, Mireille N. M. van Poppel
{"title":"Beyond Deterministic Fetal Programming: Intrauterine Exposures and the Multifactorial Origins of Adiposity","authors":"Gernot Desoye, Ursula Hiden, Evelyn Jantscher-Krenn, Herbert Fluhr, Jonathan C. Wells, Sonja Entringer, Mireille N. M. van Poppel","doi":"10.1111/obr.70133","DOIUrl":"10.1111/obr.70133","url":null,"abstract":"<p>Excess adiposity is not a recently developed problem but has existed since at least the upper Paleolithic, allowing evolutionary selection pressures to adapt the physiology of the pregnant woman and the feto-placental unit for maternal and fetal protection. Disturbances of the intrauterine environment, in particular metabolic derangements early in pregnancy, such as in women with diabetes and/or obesity, may lead to fetal hyperinsulinaemia. This often results in neonatal adiposity, which may in turn increase the risk for childhood adiposity. In this review, we summarize evidence on possible underlying mechanisms and factors that moderate the association between in utero exposure and childhood adiposity focusing on pregnancies in women with diabetes or obesity. We conclude that in humans causal evidence is missing for fetal programming of adiposity in the deterministic sense as often used and propose a more opportunistic framework. A variety of postnatal exposures and their interaction with the individual's genetic background contribute to the multifactorial problem of excessive adiposity, which may be further compounded by varying sensitivity to environmental perturbations depending on the developmental stage of the individual. We identify research gaps and describe future studies to generate causal evidence necessary.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 10","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721143","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}
Emma Bodner, Annika Gentz, Kathleen Wiencke, Nora Mehl, Haiko Schlögl
{"title":"Effectiveness of Mobile Application-Based Multimodal Behavioral Interventions on Weight Loss in Obesity: A Systematic Review and Meta-Analysis.","authors":"Emma Bodner, Annika Gentz, Kathleen Wiencke, Nora Mehl, Haiko Schlögl","doi":"10.1111/obr.70221","DOIUrl":"https://doi.org/10.1111/obr.70221","url":null,"abstract":"<p><strong>Background: </strong>Healthcare systems face increasing demands in chronic disease management such as obesity. Mobile applications offer scalable tools for weight management, ranging from simple trackers to prescribable digital therapeutics.</p><p><strong>Objective: </strong>This review evaluates the effectiveness of fully remote, app-based interventions using a multimodal approach for weight loss in adults with obesity. Complying with international guidelines, these interventions combine behavior change strategies for diet, physical activity, and/or psychosocial education.</p><p><strong>Methods: </strong>A systematic literature search was performed. Eligible studies were assessed using the Cochrane Risk of Bias Tool 2 and the Grading of Recommendations, Assessment, Development and Evaluation approach for certainty of evidence. A meta-analysis was performed for body weight outcomes.</p><p><strong>Results: </strong>Twelve randomized controlled trials and five systematic reviews were included, reporting changes in body weight or body mass index. The standardized mean difference of body weight changes at the end of intervention was -0.50 (95% confidence interval: -0.77, -0.22), corresponding to a mean difference of -2.61 kg (-4.45, -0.78). Heterogeneity was substantial (I<sup>2</sup> = 79.2%; p < 0.0001).</p><p><strong>Conclusion: </strong>Fully remote, app-based interventions show moderate weight loss with promising potential in obesity management. However, heterogeneity between studies highlights the need for further research into potential factors with a significant influence on the results.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70221"},"PeriodicalIF":7.6,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148904630","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}
Ioanna Panagiota Kalafati, David Krongauz, Alice Bosco, Antonio Noto, Cristina Piras, Maria Kafyra, Angelica Dessì, Matteo Mauri, Luigi Atzori, Adina Weinberger, Vassilios Fanos, George V Dedoussis
{"title":"Microbiome and Metabolomics in Obesity: Advances in Understanding and Interventions Across the Lifespan.","authors":"Ioanna Panagiota Kalafati, David Krongauz, Alice Bosco, Antonio Noto, Cristina Piras, Maria Kafyra, Angelica Dessì, Matteo Mauri, Luigi Atzori, Adina Weinberger, Vassilios Fanos, George V Dedoussis","doi":"10.1111/obr.70220","DOIUrl":"10.1111/obr.70220","url":null,"abstract":"<p><p>Obesity arises from intertwined and reciprocal diet-microbiome-host pathways that reshape energy balance, insulin sensitivity, and inflammation. This review synthesizes mechanistic links between microbial functions and metabolic control, charts lifestyle-related lifecourse dynamics from birth to older age, examines how GLP-1-based therapies may perturb gut ecology and metabolite output and surveys AI/ML frameworks for multi-omics integration. Plant-based, fiber-rich dietary patterns generally enrich saccharolytic guilds, boost SCFAs production, and modulate bile acid signaling, whereas Westernized patterns favor bile-tolerant, amino acid-fermenting consortia and proinflammatory metabolites. Preclinical data suggest that incretin-based therapies remodel the microbiome-metabolome axis, but human causal mediation remains unproven and observed changes may partly reflect weight loss or metabolic improvement. Function-centered metrics outperform phylum-level ratios for translation. Harmonized longitudinal cohorts and explainable ML-derived microbial and metabolomic signatures are now pivotal to identify responder subtypes and actionable microbe-metabolite targets, enabling precision nutrition alongside pharmacotherapy across the lifespan.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70220"},"PeriodicalIF":7.6,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872265","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}
Shurui Yang, Zhongyu Huang, Sanchun Tan, Fengxia Liang, Li Chen
{"title":"Epigenomic Cascades Across Organs in Metabolic Dysfunction-Associated Steatotic Liver Disease: New Therapeutic Horizons.","authors":"Shurui Yang, Zhongyu Huang, Sanchun Tan, Fengxia Liang, Li Chen","doi":"10.1111/obr.70219","DOIUrl":"https://doi.org/10.1111/obr.70219","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disorder worldwide, affecting approximately one-third of the population and increasing the risk of severe hepatic and cardiovascular complications. Growing evidence indicates that MASLD is a systemic disease in which epigenetic changes-including DNA and RNA methylation as well as histone modifications-drive its progression by integrating metabolic and inflammatory signals across organs. This review introduces the concept of \"networked epigenome cascades\" and highlights how epigenetic alterations in extrahepatic metabolic organs contribute to insulin resistance (IR) and systemic inflammation. MASLD is thereby reframed as a disorder of systemic epigenomic miscommunication rather than a liver-only disease. We further discuss preclinical and emerging interventions, with an emphasis on natural compounds that modulate epigenomic regulation, while noting the uncertainties that remain regarding their translational potential for MASLD. By positioning the epigenome as a central mechanism, this review underscores its promise for biomarker development and mechanistically targeted interventions, although robust validation in humans is still required.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70219"},"PeriodicalIF":7.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148862789","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}
Olubunmi Kolawole, Yanaina Chavez-Ugalde, Preeti Dhuria, Leila Fathi, Sarah Muir, Simon J Russell, Christina Vogel
{"title":"Healthy Eating Interventions in Convenience Stores and Diet-Related Outcomes: A Systematic Review.","authors":"Olubunmi Kolawole, Yanaina Chavez-Ugalde, Preeti Dhuria, Leila Fathi, Sarah Muir, Simon J Russell, Christina Vogel","doi":"10.1111/obr.70217","DOIUrl":"https://doi.org/10.1111/obr.70217","url":null,"abstract":"<p><strong>Introduction: </strong>Convenience stores are a key food source in many communities but often provide limited healthy options. This systematic review examines the impact of healthy eating interventions in convenience stores on diet-related outcomes across high-income countries.</p><p><strong>Methods: </strong>This systematic review was conducted using seven databases and gray literature sources. Eligible studies were published between January 2005 and June 2024. Eligible studies evaluated healthy eating strategies or interventions in convenience stores and reported diet-related outcomes. This study was registered with PROSPERO (CRD2024538968) and reported according to PRISMA guidelines.</p><p><strong>Results: </strong>Twenty-eight studies met the inclusion criteria: 20 intervention studies, four observational studies, and four gray literature reports. Interventions included changes to the availability, positioning, pricing, and signage of healthy foods. Most studies reported improvements in purchasing and consumption of healthy foods, especially fruits and vegetables. Multicomponent approaches were most effective, particularly those that use availability, positioning, and signage strategies to concurrently incentivize healthy foods and disincentivize unhealthy foods. However, study quality varied, with many showing moderate to high risk of bias.</p><p><strong>Conclusion: </strong>Healthy eating strategies in convenience stores show promise for improving diet-related outcomes. The results from this review provide policy makers with evidence to justify the implementation of population-level policies that support improved availability, positioning, and signage on healthy foods in convenience store settings to improve dietary-related behaviors. Future research that uses high-quality scientific evaluation designs and cost-effectiveness assessments would further enhance the evidence base and case for policy action.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70217"},"PeriodicalIF":7.6,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849653","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}
Travis R Moore, Yuilyn A Chang Chusan, Larissa Calancie, Panos I Tamvakologos, Christina D Economos
{"title":"Harnessing Systems Science to Strengthen Community-Based Childhood Obesity Prevention: An Overview of the Literature.","authors":"Travis R Moore, Yuilyn A Chang Chusan, Larissa Calancie, Panos I Tamvakologos, Christina D Economos","doi":"10.1111/obr.70218","DOIUrl":"https://doi.org/10.1111/obr.70218","url":null,"abstract":"<p><strong>Introduction: </strong>Addressing the obesity epidemic requires understanding the complex and multilevel dynamics that shape it. Systems science can help researchers and practitioners move beyond linear causal logic. This overview identifies empirical studies using explicit systems science methods or broader systems-informed approaches to design, implement, or evaluate community-based childhood obesity prevention efforts. We report how systems methods have been applied, their contributions to tackling obesity, challenges, and opportunities.</p><p><strong>Methods: </strong>We searched Web of Science for English-language publications reporting empirical applications of systems thinking, systems science methods, or systems-informed ecological and participatory approaches in community-level childhood obesity prevention. Three reviewers screened 273 records, assessed full texts, and extracted data.</p><p><strong>Results: </strong>Ninety-eight articles met inclusion criteria. Systems approaches were used most often during intervention design (n = 50; 51.0%), followed by implementation (n = 23; 23.5%) and evaluation (n = 14; 14.3%), with some spanning multiple stages (n = 11; 11.2%). Participatory methods such as group model building deepened understanding of structural and relational drivers, and supported context-specific adaptation and cross-sector coordination. The use of systems approaches for evaluation was limited, though emerging methods (e.g., ripple-effect mapping, longitudinal network analysis, and agent-based modeling) signal growing opportunity. Barriers included limited infrastructure for cross-sector collaboration, funding misalignment, and a lack of shared or validated metrics.</p><p><strong>Conclusion: </strong>Systems science has strengthened the field's ability to visualize complexity and align stakeholders in interventions' design and implementation. Its application in evaluation and scale-up remains limited. Sustained investment in participatory capacity, longitudinal infrastructure, and systems-informed implementation is needed to strengthen community-based childhood obesity prevention.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70218"},"PeriodicalIF":7.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838514","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 Impact of Picture Books on Children's Intake, Liking, and/or Willingness to Taste Vegetables: Systematic Review.","authors":"Alissa J Burnett, Emily Denniss, Jookyeong Lee, Alison Spence, Keri McCrickerd","doi":"10.1111/obr.70212","DOIUrl":"https://doi.org/10.1111/obr.70212","url":null,"abstract":"<p><strong>Introduction: </strong>Repeated exposure is effective at increasing preschool children's vegetable acceptance and consumption; however, some parents may find it challenging to expose children to tasting a food the recommended times (> 10). This review examines the evidence for the use of picture books as an alternative strategy to promote preschool-aged children's intake, liking, and/or willingness to taste vegetables.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic search of four databases was conducted using terms for three concepts: picture/storybook exposure; AND willingness to taste, liking, or consumption of vegetables; AND child. Inclusion criteria included intervention studies examining the impact of at least one picture or storybook on preschool-aged children's intake, liking, and/or willingness to taste vegetables. Two reviewers independently screened titles, abstracts, and full texts. Data from 20% of the included studies were extracted by two authors for consistency; the remaining data were extracted by one author. Quality assessment and risk of bias were assessed using the GRADE approach and Academy of Nutrition and Dietetics Quality Criteria Checklist.</p><p><strong>Results: </strong>The review included 16 studies with a mean sample size of 85, interventions lasting between 3 days and 12 weeks, and child age ranging from 18 months to 6 years. Ten studies found that picture books increased children's vegetable intake, seven increased liking, and three increased willingness to taste vegetables.</p><p><strong>Conclusion: </strong>The evidence from this review demonstrates that picture books are effective at increasing children's intake, liking, and/or willingness to taste vegetables. Future research should include follow-up assessments and larger sample sizes.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70212"},"PeriodicalIF":7.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148816731","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":"Impact of Sleep on Glucose Metabolism in Individuals With Overweight or Obesity: A Systematic Review.","authors":"Trudy Abla Sitsofe Accorley, Patricia Casas-Agustench, Gail Rees, Kathy Redfern","doi":"10.1111/obr.70216","DOIUrl":"https://doi.org/10.1111/obr.70216","url":null,"abstract":"<p><strong>Introduction: </strong>The obesity epidemic has coincided with chronic sleep deprivation. Sleep disturbances may contribute to metabolic dysfunction in individuals with BMI ≥ 25 kg/m<sup>2</sup>. This review investigates associations between sleep patterns and glucose metabolism in this population.</p><p><strong>Methods: </strong>A PRISMA-guided search across five databases (PubMed, Embase, Cochrane, CINAHL, and MEDLINE) was conducted through January 2026. Studies examined sleep patterns and glucose metabolism in adults with BMI ≥ 25 kg/m<sup>2</sup>. Quality was assessed using the Cochrane Risk of Bias Tool 2.0 and Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Eighteen studies (7715 adults) were included from 2993 records: crossover trials (n = 7), cross-sectional studies (n = 8), controlled trials (n = 2), one cohort study. Twelve studies used objective measures; six subjective assessments. Most studies examined sleep restrictions; four extensions. Findings for sleep restriction were mixed: Three of five studies showed reduced insulin sensitivity or impaired glucose regulation, while two found no significant effect. One pilot study found one night of restriction did not affect postprandial lipemia. Poor sleep quality was associated with adverse cardiometabolic outcomes, including higher BMI; fasting glucose associations were less consistent. Methodological quality was moderate to high.</p><p><strong>Conclusion: </strong>Sleep duration and quality are associated with glucose metabolism in individuals with overweight/obesity. Sleep optimization should be integrated into metabolic health.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70216"},"PeriodicalIF":7.6,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808142","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}
Pradipta Paul, Iman Dajani, Ridhima Kaul, Ali Chaari
{"title":"The Effect of Microbiome-Modulating Therapeutics on Anthropometric and Hemodynamic Biomarkers in Metabolic Syndrome: A Systematic Review, Meta-Analysis, and Meta-Regression of Clinical Trials.","authors":"Pradipta Paul, Iman Dajani, Ridhima Kaul, Ali Chaari","doi":"10.1111/obr.70215","DOIUrl":"https://doi.org/10.1111/obr.70215","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a prevalent cardiometabolic disorder characterized by central obesity, insulin resistance, dyslipidemia, and hypertension. Microbiome-targeted therapies with probiotics, prebiotics, and synbiotics may improve outcomes by modulating metabolism, inflammation, and blood pressure.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) in adults with MetS. Searches through April 2023 identified eligible RCTs, yielding 19 studies and 21 independent comparisons. Pooled mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random effects model. Subgroup analyses and meta-regressions examined moderators and heterogeneity.</p><p><strong>Results: </strong>A total of 19 studies comprising 21 trial comparisons were included. Microbiome-modulating interventions were associated with modest reductions in waist circumference and body weight (BW), indicating improvements in central adiposity. In contrast, effects on body mass index (BMI) were limited, and no meaningful changes were observed in systolic or diastolic blood pressure (DBP). Subgroup and meta-regression analyses suggested that higher microbial dose, longer intervention duration, and greater baseline adiposity were associated with more pronounced anthropometric responses. Moderate heterogeneity was observed across several outcomes.</p><p><strong>Conclusions: </strong>Microbiome-targeted therapies reduced waist circumference (WC) and BW in MetS but had no effect on BMI, systolic blood pressure (SBP), or DBP. These safe interventions may complement lifestyle strategies. Larger, standardized trials with microbiome profiling are needed to refine therapeutic use. These findings support a potential adjunctive role for microbiome-targeted therapies in MetS, particularly for central adiposity, though standardized, longer duration trials with microbiome profiling are needed to clarify clinical utility.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70215"},"PeriodicalIF":7.6,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808205","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}
Wael Almahmeed, Juan S Barajas-Gamboa, Mohammad Zubaid, Ebaa Al Ozairi, Abdullah Shehab, Khalid Al-Rasadi, Charbel Abi Khalil, Noor Al Busaidi, Fahad Al Sindi, Zuhier Awan, Tomader Ali, Khaldoon Al-Humood, Fatheya Al Awadi, Mohammed Al Hadad, Manal Al Kindi, Khalid Al Habib, Khalid Al Waili, Maryam Alsaeed, Adel Tash, Hani Sabbour
{"title":"Targeting Overweight and Obesity Phenotypes for Secondary Prevention of Cardiovascular Disease: A Call to Action for the Middle East and Beyond.","authors":"Wael Almahmeed, Juan S Barajas-Gamboa, Mohammad Zubaid, Ebaa Al Ozairi, Abdullah Shehab, Khalid Al-Rasadi, Charbel Abi Khalil, Noor Al Busaidi, Fahad Al Sindi, Zuhier Awan, Tomader Ali, Khaldoon Al-Humood, Fatheya Al Awadi, Mohammed Al Hadad, Manal Al Kindi, Khalid Al Habib, Khalid Al Waili, Maryam Alsaeed, Adel Tash, Hani Sabbour","doi":"10.1111/obr.70204","DOIUrl":"10.1111/obr.70204","url":null,"abstract":"<p><p>Although there are conflicting clinical data on the efficacy of weight reduction in reducing secondary events in patients with comorbid overweight and obesity (OAO) and cardiovascular disease (CVD), there is excellent epidemiological and biological evidence of a cause-effect relationship between OAO, CVD, and other systemic complications. There is also new interventional evidence that pharmacotherapies improve cardiovascular, hepatic, and renal outcomes in individuals with OAO and pre-existing CVD. New trial data confirm that not all weight loss strategies are equal in terms of reducing cardiovascular risk. Using Global Burden of Disease data and a pooled analysis of registry data on ~30,000 patients with CVD, we estimate that about 34 million patients across the Middle East could benefit from secondary prevention of CVD by targeting OAO phenotypes. Implementing secondary prevention in practice will require updating clinical guidelines on both obesity management and CVD secondary prevention, as well as policy changes that allow for reimbursement. Crucially, it will also require a philosophical shift that there exist distinct OAO phenotypes for which treatment success is not solely dictated by weight loss. The cumulative burden of future cardiovascular risk is set to increase, mandating comprehensive strategies to implement secondary prevention in at-risk groups, including children.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70204"},"PeriodicalIF":7.6,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808123","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}