Obesity Medicine最新文献

{"title":"Sustaining metabolic health after GLP-1 RA discontinuation: Lifelong obesity care and practical tips for clinicians","authors":"Andrej Belančić","doi":"10.1016/j.obmed.2026.100707","DOIUrl":"10.1016/j.obmed.2026.100707","url":null,"abstract":"<div><ul><li><span>•</span><span><div>Real-world outcomes after GLP-1RA discontinuation depend on clinician approach, follow-up quality, and patient support.</div></span></li><li><span>•</span><span><div>Without structured lifestyle intervention and interdisciplinary care, patients risk weight regain, relapse, and sarcopenia.</div></span></li><li><span>•</span><span><div>Lifelong management, including behavioral and psychological support, is essential to sustain metabolic health and prevent the chronic, relapsing nature of obesity from undermining therapy gains.</div></span></li></ul></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100707"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-inflammatory eating in primary care: The Dietary Inflammatory Index and its role in managing type 2 diabetes","authors":"Hairya Ajaykumar Lakhani ,&nbsp;Miloni Mineshbhai Nada","doi":"10.1016/j.obmed.2026.100714","DOIUrl":"10.1016/j.obmed.2026.100714","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes mellitus (T2DM) is closely associated with chronic low-grade inflammation, which contributes to insulin resistance, β-cell dysfunction, and increased cardiovascular risk. Diet is a major modifiable determinant of this inflammatory state; however, nutritional counseling in primary care often emphasizes caloric intake or macronutrient distribution rather than inflammatory effects.</div></div><div><h3>Aim</h3><div>To review the Dietary Inflammatory Index (DII) and assess its relevance as a clinical tool for understanding and managing diet-related inflammation in patients with type 2 diabetes in primary care.</div></div><div><h3>Methods</h3><div>This narrative review describes the development and methodology of the DII and examines biological mechanisms linking diet-induced inflammation to T2DM. Evidence from observational studies and meta-analyses evaluating associations between DII scores, diabetes risk, glycemic control, and disease severity is summarized, with a focus on clinical applicability.</div></div><div><h3>Results</h3><div>Higher DII scores, reflecting pro-inflammatory dietary patterns characterized by refined carbohydrates, saturated fats, and ultra-processed foods, are consistently associated with increased risk of T2DM, poorer glycemic control, and higher HbA1c levels. Conversely, lower (negative) DII scores, associated with diets rich in fruits, vegetables, whole grains, legumes, omega-3 fatty acids, and polyphenols, are linked to reduced inflammatory markers and improved insulin sensitivity. The DII provides a standardized measure of dietary inflammatory potential that may support individualized dietary counseling in primary care.</div></div><div><h3>Conclusion</h3><div>The Dietary Inflammatory Index offers a clinically relevant framework for incorporating inflammation-focused dietary assessment into the management of type 2 diabetes. By shifting dietary counseling toward food quality and inflammatory potential, the DII may complement existing lifestyle interventions in primary care. Further longitudinal and interventional studies are required to determine whether DII-guided dietary modification leads to sustained improvements in glycemic and inflammatory outcomes.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100714"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutrition transition sparks adolescent obesity epidemics","authors":"Adrian A. Mabalay","doi":"10.1016/j.obmed.2026.100708","DOIUrl":"10.1016/j.obmed.2026.100708","url":null,"abstract":"<div><div>Recent evidence from Bangladesh indicates that adolescent girls experience obesity rates nearly 50% higher than boys, with socioeconomic inequalities strongly influencing these results. In contrast, data from the Philippines show no notable gender difference in adolescent obesity, although wealth and urban residence remain important risk factors. These contrasting cases illustrate how Asia's nutrition transition, the changes in diet and lifestyle that come with economic development, is generating differing patterns in adolescent obesity. This correspondence contextualizes the findings in Bangladesh alongside Philippine data, highlights socioeconomic and gender differences, and underscores the urgent need for context-specific, gender-sensitive, and double-duty interventions that address the rising obesity epidemic and, at the same time, prevent undernutrition.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100708"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ferroptosis as a potential therapeutic target for obesity-related metabolic diseases: A review","authors":"Amjad Mahmood Qadir ,&nbsp;Rebaz Anwar Omar","doi":"10.1016/j.obmed.2026.100710","DOIUrl":"10.1016/j.obmed.2026.100710","url":null,"abstract":"<div><div>Obesity and associated metabolic disorders, impacting over 1 billion individuals worldwide with a projected 13% prevalence among adults by 2025 according to WHO estimates, contribute to comorbidities such as type 2 diabetes, NAFLD, and cardiovascular disease through mechanisms of chronic inflammation, insulin resistance, and organ dysfunction, thereby requiring innovative therapies beyond lifestyle modifications. Ferroptosis, an iron-dependent controlled cell death that differs from apoptosis—marked by iron accumulation, lipid peroxidation of polyunsaturated fatty acids via the Fenton reaction, depletion of GPX4, and mitochondrial shrinkage—emerges as a significant factor in the pathophysiology of obesity. In obese adipose tissue, liver, and pancreas, impaired iron homeostasis increases labile iron, triggering ferroptotic signalling through p53 and ACSL4, while inhibiting GPX4 and NRF2, thereby worsening metaflammation, lipotoxicity, and β-cell dysfunction; preclinical models demonstrate that inhibitors mitigate steatosis and glucose intolerance, whereas controlled induction in hypertrophic adipocytes reduces fat accumulation. This dual function—harmful in organ damage but protective against adipogenesis—establishes ferroptosis modulators (e.g., iron chelators, ferrostatin-1, GPX4 agonists) as potential redox-balancing therapies. This review consolidates processes, preclinical findings, and translational deficiencies, promoting focused strategies to address the obesity epidemic.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100710"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147858544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nano-enabled therapeutics for obesity: A review","authors":"Sheetal Sharma","doi":"10.1016/j.obmed.2026.100711","DOIUrl":"10.1016/j.obmed.2026.100711","url":null,"abstract":"<div><div>Obesity is a complex, multifactorial metabolic disorder characterised by excessive adipose tissue accumulation, contributing to serious comorbidities including type 2 diabetes mellitus, cardiovascular disease, and chronic systemic inflammation. Conventional therapeutic approaches encompassing lifestyle modification, pharmacotherapy, and bariatric surgery remain limited by poor long-term adherence, systemic side effects, and insufficient tissue specificity. Nanotechnology has emerged as a transformative strategy to overcome these limitations, enabling targeted, controlled, and efficient delivery of therapeutic agents directly to adipose tissue. This review provides a comprehensive and critically integrated overview of nano-enabled therapeutic strategies for obesity, with particular emphasis on adipose tissue-targeted modulation and metabolic reprogramming. The biology of white, brown, and beige adipocytes is first examined to establish a mechanistic framework for therapeutic targeting. Subsequently, major nanocarrier platforms including lipid-based systems, polymeric nanoparticles, inorganic nanomaterials, biomimetic carriers, and stimuli-responsive smart nanocarriers are critically evaluated alongside active and passive targeting strategies. The roles of nanocarriers in delivering small-molecule drugs, gene-based therapeutics, nutraceuticals, and combination regimens are discussed. Safety considerations, translational barriers, and future directions including precision nanomedicine and artificial intelligence integration are also addressed.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100711"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing glycemic control in type 2 diabetes: Clinical outcomes of monotherapy versus combination therapy","authors":"Dharmalingam Kirubakaran ,&nbsp;Banuppriya Palani ,&nbsp;Renu Vajjiravelu ,&nbsp;Santhoshkumar Jayakodi ,&nbsp;SenthamilSelvi Poongavanam","doi":"10.1016/j.obmed.2026.100706","DOIUrl":"10.1016/j.obmed.2026.100706","url":null,"abstract":"<div><div>Type 2 diabetes mellitus (T2DM) represents a chronic metabolic disease characterized by insulin resistance and progressive β-cell function loss. The pharmacological treatment protocols aim to achieve stable glycemic control with minimal long-term complications and side effects. Monotherapy is the standard of care in early disease stages, but as patients progress through progressively worse disease stages, they will need some type of combination therapy. This review is to evaluate the clinical outcomes of monotherapy and its comparison with combination therapy; we emphasise glycemic control or management, cardiovascular outcomes, body weight monitoring, hypoglycemia risk, adverse complications against drug adherence compliance and quality of life. This review novelty was clinical and real-world data supporting dual or triplet therapy for better and more durable glycemic control, although treatment should be personalized according to the characteristics of each individual.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100706"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147952184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanotechnology-enabled targeted delivery of incretin therapies for the treatment of obesity and metabolic disorders","authors":"Daniel Ejim Uti ,&nbsp;Josephine E. Egbung ,&nbsp;Esther Ugo Alum ,&nbsp;Inalegwu Bawa ,&nbsp;Samuel Ali Agada ,&nbsp;Celestine O. Ogbu ,&nbsp;Okechukwu Paul-Chima Ugwu","doi":"10.1016/j.obmed.2026.100712","DOIUrl":"10.1016/j.obmed.2026.100712","url":null,"abstract":"<div><div>Obesity is a significant health issue worldwide, and a key risk factor for type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), non-alcoholic fatty liver disease (NAFLD), and related complications. Incretin-based therapies, especially glucagon-like peptide-1 receptor agonists (GLP-1RA) and Incretin-based therapies, particularly <em>glucagon-like peptide-1 (GLP-1)</em> and dual or triple agonists targeting glucose-dependent insulinotropic polypeptide (GIP) have enhanced the metabolic regulation and therapy of obesity. Nevertheless, their clinical use is limited by enzymatic degradation, short biological half-life, low bioavailability, frequent administration, and systemic adverse effects. This review looks into the physiological functions of incretin hormones, the primary constraints of the present incretin-based treatment, and how nanotechnology can enhance their administration. It reviews lipid-based, polymeric, biomimetic, and stimuli-responsive nanocarriers looking at the benefits of peptide stability, release control, oral, injectable delivery, and targeting to metabolically important tissues, including the liver, adipose tissue, and brain. Formulation strategies that are included in the review development include polyethylene glycol (PEG) and biomimetic coatings, and newer strategies that include artificial intelligence (AI) are not yet widely explored, but the concepts have been intergraded. On the whole, nanotechnology has the potential to enhance incretin therapy but additional studies on safety, scalable manufacturing and clinical translation are required before such systems can be used in medical care.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100712"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147951547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene-diet interactions in obesity: Precision nutrition strategies for type 2 diabetes prevention","authors":"Polu Picheswara Rao ,&nbsp;Yatin Kumar Sharma","doi":"10.1016/j.obmed.2026.100709","DOIUrl":"10.1016/j.obmed.2026.100709","url":null,"abstract":"<div><h3>Purpose of review</h3><div>Obesity and type 2 diabetes mellitus (T2DM) represent converging global epidemics demanding more targeted prevention strategies than population-averaged dietary guidelines can deliver. This review synthesises current evidence on gene-diet interactions as the molecular foundation of precision nutrition for T2DM prevention, critically evaluating how genetic stratification at key susceptibility loci particularly <em>FTO</em>, <em>MC4R</em>, <em>PPARG</em>, and <em>TCF7L2</em> can inform individualised dietary intervention in high-risk populations.</div></div><div><h3>Recent findings</h3><div>Large-scale GWAS meta-analyses have identified over 500 BMI-associated loci, and polygenic risk scores demonstrate robust independent associations with T2DM incidence across diverse populations. FTO risk allele carriers exhibit amplified adiposity under high-fat dietary exposures, while Mediterranean and higher-protein patterns substantially attenuate this disadvantage. PPARG Pro12Ala carriers demonstrate genotype-dependent lipid benefits from omega-3 supplementation, and TCF7L2 T allele carriers face markedly greater T2DM risk under high-glycaemic-load conditions while achieving greater glycaemic benefit from structured dietary intervention. Evidence from PREDIMED-Plus, POUNDS Lost, and Food4Me confirms dietary quality reduces T2DM risk equivalently across polygenic risk strata, though prospective genotype-concordant dietary assignment trials have not yet demonstrated superiority over standard approaches. Multi-omics integration and artificial intelligence-driven optimisation exemplified by the NIH Nutrition for Precision Health trial and a landmark 2025 phase III AI-powered diabetes prevention RCT represent the emerging translational frontier.</div></div><div><h3>Summary</h3><div>Gene-diet interactions at key susceptibility loci are biologically robust and clinically meaningful. Translating these findings equitably into scalable T2DM prevention requires purpose-designed phase III trials, cross-ancestry genomic research, multi-omics integration, and structural investment in equitable implementation across diverse populations globally.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100709"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147952183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reprogramming metabolic dysfunction in diabetes: The emerging role of taurine from molecular mechanisms to clinical translation","authors":"Shrushti Ambade ,&nbsp;Siddhi S. Sandekar ,&nbsp;Radheshyam T. Lohiya ,&nbsp;Swati N. Lade ,&nbsp;Diksha S. Undirwade ,&nbsp;Milind J. Umekar ,&nbsp;Sushil S. Burle ,&nbsp;Aarti S. Zanwar","doi":"10.1016/j.obmed.2026.100713","DOIUrl":"10.1016/j.obmed.2026.100713","url":null,"abstract":"<div><div>Diabetes mellitus is a complex metabolic disorder marked by high blood sugar, insulin resistance, β-cells dysfunction, oxidative stress, inflammation, and mitochondrial dysfunction. Current treatments mainly focus on controlling blood sugar but do not fully tackle these related causes. Taurine, a sulfur-containing amino acid , has emerged as a multi-functional metabolic regulator with protective effects. This review summarizes that taurine affects important signaling pathways, including AMPK and PI3K/Akt, improves mitochondrial function, manages calcium balance, attenuates oxidative stress primarily by reducing mitochondrial ROS production and enhancing endogenous defense systems, and protects the integrity of pancreatic β-cells. Taurine also plays a role in the metabolism of bile acids by combining with primary bile acids to make taurine-conjugated bile salts. These salts act as signaling molecules through receptors like FXR and TGR5, which affect the gut microbiota and metabolic balance, indicating a broader role as metabolic regulators. Preclinical and early clinical studies have shown improvements in insulin sensitivity, fat metabolism, and inflammation, as well as a favourable safety and tolerability profile. However, current clinical evidence is limited due to small sample sizes, short durations of studies, and differences in dosing and study goals. Therefore, even though the basic and practical findings are promising, strong, large-scale, long-term clinical trials and studies focused on biomarkers are necessary to confirm taurine as a clear therapeutic target for diabetes management.</div></div>","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"61 ","pages":"Article 100713"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147995385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond class effects: The need for agent-level stratification and hierarchical composite analysis in cardiovascular outcome trials","authors":"Andrej Belančić ,&nbsp;Bojan Jelaković","doi":"10.1016/j.obmed.2026.100683","DOIUrl":"10.1016/j.obmed.2026.100683","url":null,"abstract":"","PeriodicalId":37876,"journal":{"name":"Obesity Medicine","volume":"60 ","pages":"Article 100683"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}