Obesities

The rise in obesity and its associated health problems increases the need for therapeutic approaches such as bariatric surgery. Therefore, this study aims to explore the changes in the anthropometric and body composition characteristics of patients undergoing bariatric surgery. A retrospective longitudinal study was conducted in subjects ≥ 18 y who underwent bariatric surgery and attended one nutrition appointment before and after surgery. Information on their sex, age, weight, fat mass (kg and %), fat-free mass (kg and %), and skeletal muscle mass, obtained using bioelectrical impedance, and on their waist circumferences was collected. Their BMIs and skeletal muscle mass indexes were calculated. The differences in the anthropometric and body composition parameters between pre- and post-surgery were also calculated. The participants were grouped by sex, age groups (18–44 y and 45–69), and type of surgery (Roux-en-Y gastric bypass and gastric sleeve). The variables are presented as n (%) and as means (SDs) or medians (interquartile ranges). Student’s t-test and the Mann–Whitney test were employed (p < 0.05). The sample consisted of 57 subjects (aged 18–69 years; 75% women). Between the pre- and post-surgical periods (63 (42) days), their weight (mean: 103.0 (SD: 16.3) kg vs. 91.2 (14.2) kg, p < 0.001); BMIs (37.9 (4.2) kg/m² vs. 33.6 (4.1) kg/m², p < 0.001); waist circumferences (116.2 (12.4) cm vs. 105.7 (12.3) cm, p < 0.001); % fat mass (45.5 (6.0) vs. 41.0 (8.0), p < 0.001); skeletal muscle mass (32.8 (7.4) kg vs. 30.3 (6.5) kg, p < 0.001); and skeletal muscle mass indexes (12.0 (1.8) kg/m² vs. 11.1 (1.7) kg/m², p < 0.001) decreased; meanwhile, their % fat-free mass increased (54.7 (6.0) vs. 59.0 (8.0), p < 0.001). Most of these changes occurred regardless of sex, age, or type of surgery. Shortly after bariatric surgery, patients show a better nutritional status and body composition. Full article

Background/Objectives: Metabolic syndrome (MetSy) comprises a cluster of risk factors—including obesity, dyslipidaemia, hypertension, and impaired glucose metabolism—that increase the risk of cardiovascular disease, type 2 diabetes, and other conditions. There are close ties between the complications and outcomes of obesity and MetSy. The practical value of MetSy as a distinct diagnosis in primary care remains uncertain. This study aimed to explore general practitioners’ (GPs) perspectives on the utility of MetSy for diagnosing and managing patients in light of evolving concepts in the field of metabolic health. Methods: A qualitative study design was employed, with semi-structured interviews conducted among 15 GPs in rural Western Australia. Participants were recruited via GP networks with convenience and snowball sampling. Transcribed interviews were thematically analysed using Braun and Clarke’s reflexive approach, with iterative coding, theme identification, and member checking to ensure trustworthiness. Results: GPs generally recognized MetSy as a constellation of risk factors that heighten the risk of cardiovascular disease. Insulin resistance was frequently identified as a unifying pathophysiological driver. Nevertheless, most participants did not routinely diagnose MetSy in clinical practice, rather focusing on treating individual component conditions (e.g., obesity, hypertension, dyslipidaemia) due to readily available disease-specific guidelines. Only a minority of GPs actively used the MetSy concept for patient education to highlight interconnected risks and the potential benefits of holistic lifestyle interventions. Paucity of dedicated MetSy management guidelines and uncertainty around diagnostic criteria further hindered routine application of the syndrome in practice. Conclusions: While GPs are aware of MetSy and its broad implications, few use it as a distinct clinical tool. Development of tailored guidelines and expanded educational resources would empower GPs to integrate a more holistic, MetSy-focused approach to patient care. Full article

Obesity represents a global health challenge, with a critical and urgent need for long-term, sustainable management strategies. Tirzepatide is a novel dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist. At first approved for the treatment of type 2 diabetes mellitus, tirzepatide represents one of the latest clinically approved and commercially available pharmacological options for obesity management. This narrative review aimed to synthesize existing clinical evidence on the efficacy and safety of tirzepatide in non-diabetic obese individuals. A comprehensive literature search was conducted using the PubMed, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar databases to identify relevant clinical trials, meta-analyses, and original studies assessing the weight-loss impact of tirzepatide from 2022 onwards. Synthesized evidence indicated that tirzepatide achieved up to 20.9% weight loss over 72 weeks (SURMOUNT-1), 18.4% after lifestyle intervention (SURMOUNT-3), 17.5% in Chinese adults (SURMOUNT-CN), and 25.3% with continued treatment over 88 weeks (SURMOUNT-4). Meta-analyses confirmed higher odds of ≥5–20% weight loss versus semaglutide and liraglutide, significantly reducing body mass index, waist circumference, blood pressure, and atherosclerotic cardiovascular disease risk. Health-related quality of life improved with greater weight loss, and gastrointestinal side effects (nausea, diarrhea, constipation) were common but mild to moderate, with <5% treatment discontinuation. Tirzepatide achieved significant weight loss, cardiometabolic benefits, and improved quality of life in non-diabetic obese individuals, but further research is needed on long-term efficacy, safety, and clinical application. Full article

Obesity is one of the most pressing global public health challenges of the 21st century, affecting over a billion people worldwide. Poland, like many industrialized countries, is experiencing a rapid increase in obesity prevalence across all age groups. This review provides a comprehensive analysis of the obesity trends in Poland in relation to global patterns, emphasizing the complex interplay of dietary habits, physical inactivity, screen time, socioeconomic determinants, and gut microbiota composition. Special attention is given to the health and economic consequences of obesity and the inefficiencies in Poland’s public health response. The article also discusses novel research directions, including the role of hypothalamic BNC2 neurons and NK2R receptors in appetite regulation and energy expenditure, as well as the cellular heterogeneity of adipose tissue. These discoveries may open new avenues for personalized obesity therapies. The findings underscore the urgent need for coordinated, interdisciplinary strategies at the national and international levels to reduce the burden of obesity and improve long-term health outcomes. Full article

The increasing prevalence of excess body weight and physical inactivity among young adults raises concerns about their impact on dynamic postural control. This study aimed to examine the relationship of nutritional status and physical activity level (PAL) with dynamic postural balance in young adults. A cross-sectional study was conducted with 189 young adults (81 females and 108 males; aged 18–29 years). Nutritional status was determined using BMI, and PAL was assessed with the IPAQ-SF. Dynamic postural balance was measured using the Modified Star Excursion Balance Test (SEBTm) in three directions: anterior, posteromedial (PM), and posterolateral (PL). Regression analysis showed no significant associations in the anterior direction (adjusted model by sex R² = 0.051; p > 0.05). However, for the PM direction, the adjusted model (R² = 0.289) identified nutritional status (B = 2.784; p = 0.015), PAL (B = 2.962; p = 0.011), and sex (B = 8.248; p < 0.001) as significant predictors of postural balance performance. Similarly, in the PL direction, the adjusted model (R² = 0.275) confirmed significant associations for nutritional status (B = 2.413; p = 0.004), PAL (B = 4.203; p = 0.031), and sex (B = 7.712; p < 0.001). These findings suggest that both nutritional and behavioral factors contribute to dynamic balance performance in young adults, particularly in directions with greater postural demands. Full article

An increasingly obese population has spread worldwide. But what causes so many people to be overweight or obese? Obesity is also one of the most significant public health problems in Finland, as the obesity rate in Finland has increased over the past two decades and is now much higher than the EU average, with every second Finn classified as at least overweight. Finland will be used as a case study, as we have been monitoring the fitness and body weight of Finnish recruits annually since the 1970s and therefore have comprehensive reliable data to use for the period. This article will review existing reports in the fields of obesity and societal development focusing on the Nordic countries. As far as possible, different social phenomena will be discussed in separate sections to try to find out if there is something in societal development that could be a major cause of this obesity epidemic. This article will also give some suggestions on what could be done in the future to slow down the negative trend. Full article

Obesity remains a complex global health issue, necessitating multifaceted treatment approaches. Injectable pharmacotherapies have emerged as effective strategies to manage obesity by targeting metabolic pathways that regulate appetite, energy expenditure, and fat distribution. This review explores the mechanisms, clinical efficacy, and safety profiles of key injectable agents, including GLP-1 and GIP receptor agonists and lipolytic compounds. Additionally, it highlights the aesthetic challenges following significant weight loss, such as skin laxity, and discusses the role of biostimulators and non-invasive technologies in mitigating these effects. Despite the therapeutic promise of injectable agents, their widespread application is hindered by adverse effects, high costs, and accessibility issues. This paper underscores the need for integrative treatment models that combine pharmacological interventions with aesthetic and behavioral therapies to optimize patient outcomes. Future research should focus on refining personalized protocols and expanding the accessibility of these treatments to diverse populations. Full article

The aim of this study was to analyze trends in rates of obesity amongst Mississippi adults between 2017 and 2023 based on five health determinants: gender, education, age, race, and socioeconomic status. We calculated standard errors using Microsoft Excel and performed trend analysis using Joinpoint Regression. Obesity prevalence among men showed a statistically significant increasing trend from 2017 to 2023, with an Annual Percent Change of 0.86%. Among adults with a college-level education, obesity prevalence significantly increased by 2.33% per year. For most age groups, obesity prevalence did not show statistically significant trends from 2017 to 2023, indicating relatively stable rates over time. There was a significant annual increase of 0.65% from 2017 to 2023 for African Americans. From 2022 to 2023, there was a statistically significant decrease in obesity prevalence for Hispanics. There was an annual increase of 0.70%, which was not statistically significant, for Whites. For the combined ≥USD 50,000 income group, obesity prevalence increased significantly between 2017 and 2019. Obesity remains a critical public health issue with widespread health consequences. Future research should explore the long-term impact of these trends and assess the effectiveness of ongoing interventions to guide more precise strategies for obesity prevention and management. Full article

Obesity is a complex chronic condition with multifactorial causes. Among these, psychological stress and mental health have emerged as significant contributors to the development and maintenance of obesity in adults. Chronic stress can influence eating behaviors, metabolic processes, and lifestyle habits in ways that promote weight gain. Likewise, mental health issues, such as depression, anxiety, and poor emotional regulation, often intertwine with obesity, creating a vicious cycle. This opinion paper discusses the psychological mechanisms linking stress and obesity, including stress-induced eating and impaired self-regulation, and examines the role of mental health and emotional regulation in eating behaviors. Interventions addressing stress and psychological well-being—ranging from cognitive-behavioral therapy and mindfulness-based techniques to stress management and other therapeutic approaches—are explored as essential components of effective obesity treatment. The evidence suggests that incorporating stress reduction and mental health support into obesity interventions can improve outcomes. Ultimately, obesity management requires a holistic approach that includes not only diet and exercise, but also the crucial psychological dimensions of stress and emotional health. Full article

Disordered eating, such as binge-eating and loss of control eating (LOCE), contribute to suboptimal weight loss and weight regain in some patients who undergo weight loss surgery (WLS). Despite robust evidence linking disordered eating and poor WLS outcomes, there is no consensus on standardized screening and treatment practices for this population. To address this gap, our team conducted a literature review using Ovid MEDLINE, Scopus, CINAHL, EMBASE, and Cochrane CENTRAL, focusing on studies examining screening and treatment of disordered eating in WLS populations. Our review identified key findings related to (a) screening and diagnostic tools, including semi-structured interviews and self-report measures, and (b) psychotherapeutic interventions, including cognitive behavioral therapy (CBT) and other modalities. Findings are inconclusive but suggest avenues for future research examining the routine implementation of post-WLS screening and treatment protocols (including adjunctive pharmacotherapy) for disordered eating. Full article

Background: Complete heart block (CHB) is a cardiac conduction disorder that can be fatal if not treated promptly. Malnutrition has been shown to have a significant impact on various cardiac conditions. Aim: The objective was to determine if the nutritional status influences the outcomes in patients with CHB. Methods: A retrospective study was conducted using the United States Inpatient Sample database on patients admitted with complete heart block. Outcomes were compared between the patients with and without concomitant malnutrition. Results: The study included 37,480 patients with complete heart block, of whom 603 (1.61%) had malnutrition. Compared to patients without malnutrition, patients with malnutrition had higher adjusted in-hospital mortality rates (aOR 2.61; 95% CI 1.46–3.48), longer length of stay (LOS) (mean increase 2.23 days; p < 0.01), and higher hospital charges (mean increase USD 76,907.32; p < 0.01). The malnourished group also had significantly higher rates of cardiogenic shock (aOR 2.80; 95% CI 1.56–5.03; p < 0.01) and acute respiratory failure (aOR 2.65; 95% CI 1.67–4.22; p < 0.01). Patients with malnutrition had significantly lower rates of permanent pacemaker (aOR 0.57; 95% CI 0.38–0.86; p < 0.01) and longer delay to permanent pacemaker intervention (mean increase 1.38 days; p = 0.014). The impact on outcomes was worse in patients with severe malnutrition compared to those with mild to moderate malnutrition. Conclusions: Malnutrition is associated with significantly worse outcomes in CHB admissions, including higher mortality, resource utilization, complications, and lower and delayed pacemaker intervention. Individualized and timely nutritional interventions might potentially play a key role in improving outcomes in these patients. Full article

Childhood and adolescent obesity and its associated morbidities are increasing in part due to the ingestion of diets high in fat (HFD). Changes in the gastrointestinal microbiome have been associated with these morbidities, including insulin resistance, cardiovascular disease, and inflammatory states. The use of dietary probiotics may mitigate these microbiome-associated morbidities and improve health during maturation. Using our established model of obesity in rats consuming an HFD from weaning, we examined the gut microbiome with a single-strain probiotic in the drinking water [Lactiplantibacillus plantarum 299v (Lp299v, LP299V^®)] of adolescent and adult rats. Our main finding was a differential effect of HFD and probiotic on the gut microbiome that was associated with maturation (adolescence vs. adulthood). Specifically, probiotic treatment of adolescent rats on an HFD led to alterations in the enrichment of the gut microbiome, which were associated with the morbidities of obesity, while adult rats under the same conditions exhibited minimal changes, demonstrating differences in plasticity associated with maturation. Of particular relevance in this regard is the fact that Oscillospiraceae and Lachnospiraceae, associated with beneficial short-chain fatty acid production, were enriched in adolescent rats on an HFD and treated with Lp299v. Our data suggest that the use of probiotics in childhood and adolescence may improve health in adulthood by potentially affecting the developing gastrointestinal microbiome. Full article

Objective: To investigate the association between coffee consumption and visceral obesity (VO). Methods: We conducted a retrospective, cross-sectional, observational study using data from 45,630 participants who underwent a general health check-up program at a medical center in Japan between 2015 and 2018. After excluding participants with missing data or duplicated visits, 19,253 subjects were included in the final analysis. Visceral fat area (VFA) was measured using computed tomography (CT), and data on metabolic disorders, history of lifestyle-related diseases, coffee consumption, and other lifestyle factors were collected via a self-administered questionnaire. Results: The mean ± SD VFA was 74.0 ± 49.7 cm², and the mean ± SD age was 53.3 ± 9.8 years. The prevalence of VO (VFA ≥ 100 cm²) was 25.5%. The mean coffee consumption was 1.7 ± 1.3 cups per day. In multivariate logistic regression analysis, coffee consumption was significantly inversely associated with VO. Compared to non-coffee drinkers, the odds ratios (ORs) for VO were as follows: 1 or 2 cups/day (OR: 0.75, 95% confidence interval [CI]: 0.68–0.83), 3 or 4 cups/day (OR: 0.67, 95% CI: 0.59–0.75), and ≥5 cups/day (OR: 0.65, 95% CI: 0.53–0.80). In multiple linear regression analysis, coffee consumption was significantly associated with lower VFA (Model 3: β = −1.86, SE = 0.230, p < 0.05). Conclusions: Coffee consumption was significantly associated with lower VO. Full article

Background: Equations for estimating energy expenditure are developed for specific populations and contexts, including clinical settings, body composition variations, and age groups, to enhance precision in nutritional planning and health promotion. Objective: To compare the estimated daily energy requirements using the equations from the 2005 and 2023 Dietary Reference Intakes for Energy in sedentary adults and elderly individuals. Methods: A cross-sectional, retrospective study analyzed data from records at a university outpatient clinic using convenience sampling. Participants included sedentary individuals aged 20 years or older of both sexes. The comparison was conducted using repeated measures Analysis of Variance (rmANOVA). Results: Data from 431 individuals (80% female, mean age 43.57 ± 17.30 years) were analyzed. The 2023 equations provided higher energy estimates compared to the 2005 equations. The rmANOVA revealed a significant difference between the energy estimates (F(1, 429) = 1567.24, p < 0.001, η² = 0.02), with the 2023 equations consistently yielding higher values. Conclusions: The results indicate that the estimated energy requirements significantly increased in the 2023 equations compared with those of 2005, highlighting their relevance to clinical practice. Full article

Background: The mechanisms of diabetes remission following bariatric surgery independent of calorie restriction and weight loss remain unclear. Objectives: To undertake a systematic review and meta-analysis to investigate mechanisms underpinning diabetes remission. Methods: We included individuals with type 2 diabetes who have undergone RYGB, SG, and a very low-calorie diet (VLCD). In total, 234 studies were identified (N = 52 for qualitative; N = 40 for quantitative synthesis). Review Manager v5.4 and IBM SPSS for Windows (v28.0.1.1) were used for analysis. Results: Crude annualised diabetes relapse rates for RYGB and SG are as follows: −6.98 ± 16.19 (p = 0.046) and −2.75 ± 4.94 (p = 0.08); crude remission rates for RYGB and SG, respectively, are as follows: 39.59 ± 45.93 (p = 0.000) and 33.36 ± 33.87 SG (p = 0.006). Differences in other metabolic outcomes (standardised mean difference and 95% confidence intervals (CIs)) are BMI: ([RYGB: −2.73, 95%CI: −3.14 to −2.32, p < 0.000001) (SG: −2.82, 95%CI: −5.04 to −0.60, p = 0.01)]; HbA1c: [(RYGB: −1.58, 95%CI: −2.16 to −1.00, p < 0.00001) (SG: −1.42, 95%CI: −1.69 to −1.15, p < 0.00001)]; insulin: [(RYGB: 0.16, 95%CI: −0.19 to −0.50, p = 0.37) (SG: −3.00, 95%CI: −3.17 to −2.82, p = 0.75)]; and fat mass [(RYGB: −2.56, 95%CI: −4.49 to −0.64, p = 0.009) (SG: −1.69, 95%CI: −4.58 to 1.21, p = 0.25)]. RYGB and SG produced a significant improvement in HOMA-B measurements. Adiponectin and the Matsuda index were significantly increased with RYGB. No difference was observed for other metabolic markers (RYGB: GLP-1, GIP, leptin, ghrelin, PYY) (SG: GLP-1 and FGF19) (VLCD: leptin, GLP-1, GIP, and ghrelin). Conclusions: Diabetes remission following RYGB and SG was primarily driven by improvement in beta-cell function, with improvement in insulin resistance markers also observed for RYGB, driven by reductions in fat mass. No other metabolic mechanism explaining diabetes remission was observed based on clinical studies. Full article

Introduction: Polycystic Ovary Syndrome (PCOS) affects up to 10% of women and is associated with weight gain, insulin resistance, and potential negative body image. In some cases, PCOS can lead to eating disorders, such as anorexia nervosa, due to the psychological impact of the condition’s physical symptoms. Early identification and intervention are crucial to preventing long-term health consequences. Detailed Case Description: A 25-year-old female diagnosed with PCOS at age 15 began restricting food intake to avoid weight gain, developing anorexia nervosa. By age 17, her body mass index (BMI) had dropped to 16.65, indicating moderate thinness. At that point, she started cognitive behavioral therapy (CBT) with strong social support. Over time, her eating behaviors normalized, and ten years later, her BMI was 21.16. She also scored 4.3/5 on the Body Appreciation Scale-2 (BAS-2), indicating a healthy body image. Conclusions: Early detection and intervention are crucial for women with PCOS at risk of eating disorders and body image issues. CBT plays a key role in addressing cognitive distortions, while a supportive social network strengthens recovery. Ongoing monitoring of physical and psychological health, including BMI and BAS-2, ensures effective treatment and improved long-term outcomes for these patients. Full article

According to WHO (World Health Organization), in 2022, 43% of adults worldwide were overweight and 16% suffered from obesity. Overweight and obesity is a condition in which the body, due to the excess of consumed calories, accumulates it in the form of adipose tissue. However, this tissue is not only an energy store but also secretes numerous adipokines, mainly with pro-inflammatory effects. The mobilization of the immune system due to the accumulation of adipose tissue is called low-grade inflammation (LGI) and is a mediating factor between excess body weight and diseases such as cardiovascular disease, insulin resistance, type 2 diabetes, neurodegenerative diseases, sleep apnea, and even cancer. The aim of the review is to update reports related to dietary factors influencing the severity or alleviation of low-grade inflammation in obese people. The review used studies from PubMed and Google Scholar from the last 10 years. The results indicate that the Western diet, rich in processed foods, high levels of saturated fatty acids, simple sugars, salt, and low fiber and nutrient content (vitamins and minerals), leads to increased low-grade inflammation. On the other hand, calorie restrictions and an appropriate balance of macronutrients, fatty acids, and antioxidant or anti-inflammatory nutrients (e.g., polyphenols, vitamins A, C, and E, and selenium) may reduce the severity of LGI, reducing the risk of obesity-related diseases. Full article

The aim of this work was to analyze the trend of overweight, obesity, and body fat distribution of children and adolescents in Catamarca, northwest Argentina, in the last four decades. A data series obtained between 1982 and 2019 in the province of Catamarca was analyzed. The sample of 5596 individuals (46.41% female), between 5 and 14 years old, was grouped into four decades: 1980, 1990, 2000, and 2010. The categories of overweight and obesity, based on body mass index (BMI), were defined from the international reference IOTF. The fat distribution was defined according to the subscapular tricipital index (STI). Between 1980 and 2010, BMI increased by 2.35 kg/m², overweight varied between 13.9% and 21.0%, and obesity varied between 3.4% and 19.2%. The centralized fat distribution varied from 3.9% in 1990 to 27.3% in 2010. In the cohort analysis, and after forty years, an increase in excess weight and body fat centralization was observed in children and adolescents in Catamarca. This trend was inversely proportional to the indicators of unsatisfied basic needs (UBN). It can be concluded that improvements in economic, educational, and housing conditions were not reflected in a better nutritional status. Full article

Time-restricted eating (TRE) has gained attention as an effective approach for weight management and overall well-being by focusing on limiting the eating window, rather than reducing calories. This study explores the biopsychosocial impacts of TRE in free-living individuals using a qualitative design. Twenty-one adults (aged 27–60 years) from Western Australia who had practised TRE for at least three months were purposively recruited, and semi-structured interviews were conducted. The data were analysed using a thematic analysis to identify key themes. The participants reported a range of benefits, including weight loss, reduced joint pain, better digestion, improved mental clarity, increased energy, and a more positive body image. Socially, TRE facilitated simplified daily routines but also introduced challenges, such as disruptions to social interactions and family meal dynamics. Some mixed and negative impacts were reported, including changes in sleep and exercise patterns. These findings highlight TRE’s potential as a holistic dietary intervention. Further research, particularly well-controlled, randomised controlled trials and longitudinal studies, is needed to confirm these insights and guide their appropriate application in clinical and public health settings. Full article