Obesity Reviews最新文献

{"title":"Gender Inequality and Socio-Economic Disadvantages Associated With Obesity in Women Compared to Men: A Rapid Review and Meta-Analysis of Observational Studies From High-Income Countries.","authors":"Nana Ama Asi Danso, Paul P Fahey, Navindhra Naidoo, Rebecca Wu, Evan Atlantis","doi":"10.1111/obr.70214","DOIUrl":"https://doi.org/10.1111/obr.70214","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether obesity-related socio-economic disadvantages in wages, employment, and workplace discrimination equally affect women compared to men in high-income countries.</p><p><strong>Method: </strong>We searched databases and Google Scholar from inception to March 2025. Data on wages, employment, and perceived discrimination were pooled using random-effects meta-analysis where possible. Primary effect measures were obesity-versus-comparison ratios for continuous outcomes (wage ratio, WR) and odds ratios (OR) for dichotomous outcomes, each with 95% confidence intervals (CI), stratified by women versus men. Heterogeneity was assessed using the I² statistic and τ².</p><p><strong>Results: </strong>From 3495 screened citations, 17 studies (2004-2021) were included. Pooled effect estimates suggested greater socio-economic disadvantages among women with obesity, although subgroup differences were not statistically significant (p > 0.05). Meta-analysis revealed a significant wage penalty overall (WR = 0.95, 95% CI: 0.91-0.99; I² = 93.0%, τ² = 0.003), which appeared larger for women (WR = 0.91, 95% CI: 0.82-1.01) than men (WR = 0.96, 95% CI: 0.95-0.98). The association between obesity and employment was nonsignificant overall (OR = 0.94, 95% CI: 0.86-1.02), with a larger effect estimate for women (OR = 0.86, 95% CI: 0.69-1.06) than men (OR = 0.96, 95% CI: 0.87-1.05). Individuals with obesity were over four times more likely to report workplace discrimination (OR = 4.62, 95% CI: 1.04-20.53), with a higher, but not statistically significant, estimate for women (OR = 5.65, 95% CI: 0.57-55.89) than men (OR = 4.37, 95% CI: 0.24-79.14). Narrative synthesis confirmed consistent wage and employment penalties for women with obesity across countries.</p><p><strong>Conclusion: </strong>In high-income countries, obesity is associated with socio-economic disadvantages. A consistent pattern of stronger associations was observed for women, though statistical evidence for sex differences remains inconclusive.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70214"},"PeriodicalIF":7.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786135","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":"Summarizing the Experiences of Individuals Who Have Obesity or Larger Bodies Seeking Fertility Care: A Scoping Review.","authors":"Brooke J Hebert, Hanna Randhawa, Virginie Blanchette, Kristi B Adamo, Angela Alberga, Jean-Patrice Baillargeon, Marilou Côté, Julia Craig, Ariadne Daniel, Liz Dennett, Nicola Heslehurst, Sarah Nutter, Ian Patton, Helena Piccinini-Vallis, Ximena Ramos Salas, Katie Wadden, Taniya S Nagpal","doi":"10.1111/obr.70213","DOIUrl":"https://doi.org/10.1111/obr.70213","url":null,"abstract":"<p><p>Females who have larger bodies or obesity may be at an increased risk for experiencing infertility. Problematically, both weight or body size and infertility are stigmatized, harming quality of care. We conducted a scoping review to understand the lived experiences of patients who may be subjected to intersecting stigmas of weight and infertility in healthcare. Searches included six databases (Medline, Embase, CINAHL, PsycInfo, Scopus, and Proquest Theses and Dissertations). Data were narratively summarized. With a team of interest holders, including lived experience experts, we identified future directions for research, clinical practice, and policy. Searches yielded 2724 articles, and 13 were included. Four themes were derived: 1. Lack of education/information on the link between infertility and obesity provided to the patient and focusing on weight alone; 2. Restricted access to fertility care; 3. Lack of weight management support; and 4. Self-blame. Directions forward for research include ensuring missing perspectives are studied (i.e., partners, gender diverse individuals, and healthcare professionals), examining the impact of stigma on behavioral responses (e.g., weight loss attempts), and comparing the use of body mass index versus other comprehensive measures of excess adiposity on fertility outcomes. Shared decision-making tools to guide patient-centered discussions about fertility and body weight are needed.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70213"},"PeriodicalIF":7.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786299","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":"Rethinking Global Obesity Guidelines: Integrating Evidence, Equity and Precision (2014-2026).","authors":"Rosero-Revelo Ricardo, Tamayo Mateo, Henao Diana, Juan P Polanco, Cortés David, Juan C Alba, Giha Valeria, Camargo Camilo, Hernández Eder, Correa Ricardo, Nassar Ricardo, Cabandugama Peminda, Marcio L Griebeler, Burguera Bartolome","doi":"10.1111/obr.70209","DOIUrl":"10.1111/obr.70209","url":null,"abstract":"<p><p>Obesity remains a global health crisis characterized by substantial heterogeneity in diagnosis, management, and policy implementation. Although numerous national and international clinical practice guidelines have been published over the past decade, their translation into evidence-based and equitable care remains inconsistent. This narrative review critically evaluates 47 obesity guidelines published between 2014 and 2026 across North America, Europe, Latin America, the Asia-Pacific region, and the World Health Organization to identify conceptual, structural, and implementation gaps that continue to fragment obesity care. Despite broad recognition of obesity as a chronic, relapsing disease, most guidelines continue to rely primarily on body mass index (BMI), with limited incorporation of accessible anthropometric measures, body composition assessment, and metabolic phenotyping. Lifestyle recommendations for nutrition, physical activity, and behavioral interventions remain largely descriptive, while access to pharmacotherapy and metabolic surgery is strongly influenced by regulatory and socioeconomic factors. Emerging advances, including GLP-1 receptor agonists, dual incretin therapies, body composition-guided assessment, and anti-stigma approaches, have been only partially incorporated into routine recommendations. Rather than redefining obesity, this review proposes a pragmatic, implementation-oriented framework that integrates scalable strategies including anthropometric risk assessment, healthy dietary patterns, physical activity, behavioral support, non-stigmatizing care, and equitable access to effective therapies with selective use of precision medicine and body composition assessment. Greater harmonization of clinical, behavioral, compositional, and policy domains is needed to achieve feasible, equitable, and sustainable improvements in metabolic and functional health outcomes.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70209"},"PeriodicalIF":7.6,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786279","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":"Long-Term Metabolic Outcomes Following Bariatric Surgery: A Systematic Review, Meta-Analysis, and Meta-Regression.","authors":"Bernardo Paz Barboza, Pietro Ferrara, Lisa Ye, Lorenzo Losa, Gianluca Perseghin, Giovanni Cesana, Paolo Berta, Lorenzo Giovanni Mantovani","doi":"10.1111/obr.70211","DOIUrl":"https://doi.org/10.1111/obr.70211","url":null,"abstract":"<p><p>Bariatric surgery (BS) has short- and medium-term benefits in improving metabolic syndrome (MetS) components, but its long-term impact remains incompletely characterized. This systematic review and meta-analysis aimed to quantify the long-term effects of BS (≥ 5 years) on fasting blood glucose (FBG), HDL cholesterol, triglycerides (TG), waist circumference (WC), and systolic and diastolic blood pressure (SBP and DBP). A comprehensive literature search was conducted across relevant databases. Eligible studies included randomized controlled trials and observational cohorts reporting pre- and postsurgical metabolic outcomes after at least 5 years of follow-up. Random-effects meta-analyses and meta-regressions were performed. Fifty-four articles (49 cohorts and five RCTs), including 37,840 baseline participants, were analyzed. BS was associated with significant improvements across all outcomes, with effect sizes varying by study design. Pooled estimates ranged from -22.97 to -44.68 mg/dL for FBG, +10.25 to +11.94 mg/dL for HDL, -54.11 to -59.59 mg/dL for TG, -20.55 cm for WC, -7.82 to -9.76 mmHg for SBP, and -4.80 to -6.48 mmHg for DBP. Meta-regression showed stronger effects in patients with higher baseline values. BS provides sustained, long-term improvements in all major MetS components. However, these findings are primarily driven by studies on Roux-en-Y gastric bypass, whereas long-term data on sleeve gastrectomy remain limited. High-quality longitudinal evidence on sleeve gastrectomy is needed to improve the generalizability of these results to contemporary surgical practice.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70211"},"PeriodicalIF":7.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786174","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":"Introducing OBEClust: A Pan-European Initiative to Harmonize Obesity Prevention Research and Strengthen Translation Into Policy.","authors":"Maria Kafyra, Pelin Alpay, Anabela Marisa Azul, Fernando Fernández-Aranda, Sarah Forberger, Michael Georgoulis, Ioanna Panagiota Kalafati, Meropi D Kontogianni, Thao Lam, Eirini Marouli, Paulo Matafome, Stavroula Mougiakakou, Barbara Pakula, Julio Álvarez Pitti, João Ramalho-Santos, Katrin Scionti, Andreia Silva, Vasiliki Vavouraki, Susann Weihrauch-Blüher, Mariusz R Wieckowski, Manuel Tena-Sempere, Afshan N Malik, Dimitrios-Dionyssios Koutsouris, Jeroen Lakerveld, Karl-Heinz Wagner, Itziar Tueros, Philippe Froguel, Torsten Bohn, Paulo J Oliveira, George V Dedoussis","doi":"10.1111/obr.70210","DOIUrl":"https://doi.org/10.1111/obr.70210","url":null,"abstract":"<p><p>Obesity remains one of the most pressing public health challenges in Europe, with substantial health, social, and economic consequences. Despite extensive research and numerous national strategies, obesity prevention efforts remain fragmented across countries, limiting comparability, scalability, and policy impact. The present description introduces the collaborative effort of \"OBEClust,\" a pan-European initiative designed to harmonize obesity prevention research and policy, fostering collaboration across disciplines, sectors, and countries. OBEClust aims to create a coordinated framework that integrates research methodologies, shared data infrastructures, and knowledge translation approaches to strengthen the evidence base and support the development and implementation of effective and equitable obesity prevention strategies. The initiative brings together researchers, policymakers, and public health stakeholders to standardize core indicators, align evaluation frameworks, and promote evidence-informed policy development. By facilitating cross-country collaboration and reducing duplication of efforts, OBEClust seeks to strengthen capacity for prevention research and accelerate the implementation of effective interventions. Through harmonization and structured knowledge exchange, OBEClust addresses existing gaps between scientific evidence and policy action. This initiative provides a collaborative framework for European obesity research coordination that provides a transferable model for cross-project cooperation through methodological harmonization, structured knowledge exchange, stakeholder engagement, and evidence translation.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70210"},"PeriodicalIF":7.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786143","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":"Ethical Issues Raised by Interventions to Prevent or Treat Childhood Obesity: A Systematic Qualitative Review.","authors":"Marthe Smedinga, Michael Rossiter, Joshua R Marx, Stuart McLennan","doi":"10.1111/obr.70208","DOIUrl":"10.1111/obr.70208","url":null,"abstract":"<p><strong>Background: </strong>Efforts to control the global obesity epidemic are increasingly focusing on preventing childhood obesity. A wide range of interventions has been implemented; however, such interventions raise important ethical issues.</p><p><strong>Aim: </strong>This study aims to determine systematically the spectrum of ethical issues that are raised by interventions to prevent or treat childhood obesity.</p><p><strong>Methods: </strong>A systematic review in PubMed was conducted for publications describing and/or assessing ethical issues raised by childhood obesity interventions. Data were analyzed and synthesized using qualitative content analysis.</p><p><strong>Results: </strong>Our literature search retrieved 4637 publications of which 62 were included in the final analysis. When the ethical issues presented by the 11 different types of childhood obesity interventions were identified, it is clear that the discussion of ethical issues regarding interventions to prevent or treat childhood obesity has important gaps. However, two key overarching themes emerged across the different interventions: a lack of evidence of effectiveness and risk of harmful side effects.</p><p><strong>Conclusion: </strong>The obesity epidemic is a growing, yet largely neglected, global public health crisis. Despite there being an ethical obligation to address this crisis, it is ethically problematic that efforts to reduce childhood obesity rates have primarily focused on individual behavior. Evidence demonstrates that these lifestyle interventions are not only largely ineffective but also cause harm. A fundamental shift towards more system-level actions is needed.</p>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":" ","pages":"e70208"},"PeriodicalIF":7.6,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719697","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":"Efficacy and Safety of Bariatric Surgery in Acquired Hypothalamic Obesity: A Systematic Review and Individual Patient Data Meta-Analysis","authors":"Johannes Fessler,&nbsp;Pauline Faucher,&nbsp;Christine Poitou,&nbsp;Carsten Dirksen","doi":"10.1111/obr.70182","DOIUrl":"10.1111/obr.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This work aimed to investigate the efficacy and safety of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in adults with acquired hypothalamic obesity (HO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Publications reporting relevant outcomes in patients with HO before and after RYGB or SG were identified through a systematic literature search. Two meta-analyses were performed: one based on individual patient data (IPD) and one on case–control studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen publications including 36 unique patients with HO were included in the IPD meta-analysis. Percent total weight loss was 16.5% (95% CI, 11.6%–21.4%; <i>p</i> = 5.7 × 10⁻⁸) after a median follow-up of 31.5 months (IQR 24.0, 60.0). Weight loss after RYGB was slightly but not significantly larger compared with SG (17.4% vs. 15.2%). Type and rate of adverse events were reported to be as expected, and no major concerns were raised regarding hormone replacement therapy (HRT). Four publications including 49 patients with HO and 223 patients with common obesity were included in the case–control meta-analysis that showed a 12.5%-point lower weight loss in cases compared with controls with no major differences in the safety profile of the surgical procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bariatric surgery in patients with acquired HO induces a clinically meaningful weight loss sustained for at least 2.5 years and appears to be safe. No significant differences were observed between RYGB and SG, but weight loss is substantially lower in patients with HO compared with patients with common obesity. However, the limited evidence calls for close surveillance if bariatric surgery is more widely adopted in this group of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 9","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148300419","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":"Multilevel Nutrition Interventions for Obesity Prevention Among Children With Intellectual and Developmental Disabilities: A Systematic Review","authors":"Angela C. B. Trude,&nbsp;Zoya N. Rehman,&nbsp;Andrea L. Deierlein","doi":"10.1111/obr.70181","DOIUrl":"10.1111/obr.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childhood obesity disproportionately affects children with intellectual and developmental disabilities, in part due to additional risks, including food selectivity, metabolic differences, and systemic inequities. Given the critical role of nutrition in obesity prevention, this systematic review examines the effectiveness of nutrition-based interventions targeting intellectual and developmental disabilities across socio-ecological levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review followed PRISMA guidelines (PROSPERO ID # CRD42023493651). A search of four electronic databases (PubMed MEDLINE, PsycINFO, CINAHL, Embase) identified articles evaluating nutrition-based obesity prevention interventions for children with intellectual and developmental disabilities. Inclusion criteria encompassed interventions implemented at household, school, community, or policy levels, with outcomes measuring diet-related behaviors and obesity. Outcomes included diet-related behaviors and obesity indicators. Two independent reviewers screened articles, extracted data, and assessed quality. Articles were assessed for methodological quality and intervention effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 3531 initial citations, 10 articles met inclusion criteria. Most interventions were school-based and incorporated nutrition education, behavioral strategies, and environmental modifications. Of these, 80% targeted school-level interventions, with some extending to community and policy levels. Results showed improved diet-related behaviors, especially increased fruit and vegetable intake, though statistically significant reductions in obesity measures were not observed, likely due to small sample sizes and methodological limitations such as lack of control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Nutrition-based interventions show promise in improving dietary behaviors among children with intellectual and developmental disabilities, but evidence on obesity reduction remains inconclusive. Future research should adopt rigorous study designs and incorporate family and community engagement to enhance intervention efficacy and sustainability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 9","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148269596","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":"Malnutrition in Obesity: When BMI-Based Screening Masks Clinical Risk","authors":"Fatma Ozge Kayhan Kocak","doi":"10.1111/obr.70186","DOIUrl":"10.1111/obr.70186","url":null,"abstract":"","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 9","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148389535","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 Role of Fat-Free Mass in Weight-Related Complications: A Rapid Review and Meta-Analysis","authors":"Tadesse Asmamaw Dejenie,&nbsp;Paul P. Fahey,&nbsp;Haider Mannan,&nbsp;Mohammad Ariya,&nbsp;Evan Atlantis","doi":"10.1111/obr.70202","DOIUrl":"10.1111/obr.70202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This review synthesized evidence on the association between fat-free mass (FFM) metrics and weight-related metabolic complications in adults with overweight or obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of Medline, Embase, Web of Science, and Google Scholar (inception to October 2024) identified 32 observational studies involving 138,935 participants. Random-effects meta-analyses were conducted for type 2 diabetes (T2DM, 5 studies, <i>n</i> = 41,235), metabolic syndrome (MetS, 3 studies, <i>n</i> = 2832), cardiovascular disease (CVD, 3 studies, <i>n</i> = 8980), and non-alcoholic fatty liver disease (NAFLD, 3 studies, <i>n</i> = 4570). Heterogeneity was assessed using I². Sensitivity analyses stratification by FFM metric type were performed where feasible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Low FFM metrics were significantly associated with increased risk of T2DM (pooled RR = 1.46, 95% CI 1.11–1.91), MetS (OR = 4.48, 95% CI 2.18–9.22), CVD (RR = 2.03, 95% CI 1.27–3.26), and NAFLD (RR = 2.24, 95% CI 1.52–3.32). High heterogeneity was observed for T2DM (<i>I</i>² = 90.9%) and MetS (<i>I</i>² = 79.8%); however, sex-stratified sensitivity analyses eliminated heterogeneity for T2DM (<i>I</i>² = 0%). Narrative synthesis of remaining studies generally supported these findings, though associations varied according to FFM metric type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Low FFM-related metrics were associated with increased risk of major weight-related metabolic complications, although the strength and consistency of associations differed by FFM metric type.</p>\u0000 </section>\u0000 </div>","PeriodicalId":216,"journal":{"name":"Obesity Reviews","volume":"27 9","pages":""},"PeriodicalIF":7.6,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/obr.70202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148534636","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}