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Obesity and Overweight: Prevention, Causes and Treatment

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Public Health and Preventive Medicine".

Deadline for manuscript submissions: closed (31 May 2026) | Viewed by 24204

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Dr. Marco La Marra

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Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
Interests: neuroscience; obesity; cognitive functions; body weight regulation
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Special Issue Information

Dear Colleagues,

The global prevalence of obesity and overweight continues to rise, posing significant challenges to public health systems worldwide. Obesity is a complex condition with multifaceted causes, including genetic, behavioral, and environmental factors, and it significantly increases the risk of various chronic diseases, such as diabetes, cardiovascular disorders, and certain cancers. Understanding the underlying causes and identifying effective prevention and treatment strategies are crucial to tackling this growing epidemic.

We are pleased to invite you to contribute to this Special Issue, which aims to explore the prevention, causes, and treatment of obesity and overweight. The focus aligns with the scope of Healthcare, which addresses the improvement in health and healthcare systems globally, particularly through evidence-based practices.

This Special Issue aims to highlight innovative research on obesity prevention, causal pathways, and therapeutic interventions, offering insights into both individual and population-level strategies to mitigate the health risks associated with obesity.

In this Special Issue, original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

Behavioral interventions;
Public health policies;
Nutritional strategies;
Genetic and environmental risk factors;
Pharmacological and surgical treatments for obesity.

We look forward to receiving your valuable contributions.

Prof. Dr. Marco La Marra
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

obesity prevention
overweight management
chronic diseases
behavioral interventions
nutritional strategies
public health policies
genetic risk factors
environmental influences
pharmacological treatments
surgical interventions

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Published Papers (9 papers)

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Research

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15 pages, 330 KB

Open AccessArticle

Prevalence and Factors Associated with GLP-1 Receptor Agonist Use for Weight Management Among Overweight and Obese Adults in the Eastern Province of Saudi Arabia

by Khalid Alhussain, Zainab Alshakhs, Layla Albaqshi, Fawatim Alshaqaqiq, Mohammed Alrabiah and Rina Tripathi

Healthcare 2026, 14(3), 345; https://doi.org/10.3390/healthcare14030345 - 29 Jan 2026

Viewed by 1401

Abstract

Objectives: This study aimed to assess the prevalence and patterns of GLP-1 receptor agonist (GLP-1 RA) use for weight loss and to identify factors associated with their use among overweight and obese adults in the Eastern Province of Saudi Arabia. Methods: A cross-sectional study was conducted among overweight and obese adults aged 18 years and older residing in the Eastern Province. Data were collected in December 2024 using an online, self-administered questionnaire. Descriptive statistics were used to assess the prevalence of GLP-1 RA use, while chi-square tests and logistic regression analyses were performed to examine associations between GLP-1 RA use and relevant independent variables. Results: A total of 1264 participants were included. The lifetime prevalence of GLP-1 RA use was 18.2%, with 14.2% reporting current use. Injectable semaglutide (Ozempic) was the most commonly used medication (73.9%). Most individuals reported initiating treatment based on a doctor’s recommendation (70.4%), although 36.5% began use based on personal decision. Multivariable logistic regression identified several factors significantly associated with GLP-1 RA use, including obesity status, diabetes, prior weight-loss attempts, having family members or friends who use GLP-1 RAs, and studying or working in a health-related field. Conclusions: GLP-1 RA use is substantial among overweight and obese adults in the Eastern Province. In addition to medical conditions, social influences and involvement in health-related fields appear to shape use. These findings emphasize the need for awareness initiatives promoting appropriate GLP-1 RA use and stricter adherence to prescription guidelines. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

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10 pages, 230 KB

Open AccessArticle

Association Between Sleep Duration, Screen-Based Sedentary Time, and Weight Status Among Chinese Adolescents

by Masen Zhang, Jing Cui and Yuliang Sun

Healthcare 2025, 13(24), 3237; https://doi.org/10.3390/healthcare13243237 - 10 Dec 2025

Cited by 1 | Viewed by 1244

Abstract

Objectives: The aim of this study was to examine the association between sleep duration, screen-based sedentary time, and overweight/obesity prevalence among Chinese adolescents. Methods: A cross-sectional analysis was conducted on 6174 adolescents in Shandong Province, China, covering general demographic characteristics, sleep time, screen-based sedentary time, physical activity, and other related variables. Height and weight measurements were obtained through on-site physical examinations, while other variable data were obtained through a questionnaire. The participants were categorized based on sleep time (<8 vs. ≥8 h/d) and screen-based sedentary time (<2 vs. ≥2 h/d). Logistic regression was employed to assess the independent and combined associations. Results: The overall prevalence of overweight in the adolescents was 27.1%. Adolescents with insufficient sleep (<8 h/d) had a significantly higher rate of overweight than those with adequate sleep (29.1% vs. 25.1%, p = 0.03). Similarly, those with high screen-based sedentary time (≥2 h/d) had a higher rate of overweight than those with low screen-based sedentary time (32.6% vs. 26.4%, p = 0.012). After adjustment for confounders, insufficient sleep and high screen time were independently associated with increased odds of being overweight. While no significant multiplicative interaction was found, the combination of insufficient sleep and high screen time presented the highest risk (OR = 1.552, 95% CI: 1.162–1.911). Conclusions: Both insufficient sleep duration and excessive screen-based sedentary time are independent risk factors for overweight/obesity among Chinese adolescents. A cumulative effect is suggested, as adolescents with both behaviors face the greatest risk. Public health interventions should concurrently promote adequate sleep and reduce screen-based sedentary time to combat adolescent overweight/obesity. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

11 pages, 320 KB

Open AccessArticle

Exploring Adults’ Experiences with Tirzepatide for Weight Loss: A Mixed-Methods Study

by Shukri Adam, Fatma M. Ibrahim, Eman Abdelaziz Ahmed Dabou, Sneha Pitre, Rania Aiman and Shimaa AbdelSamad

Healthcare 2025, 13(23), 3102; https://doi.org/10.3390/healthcare13233102 - 28 Nov 2025

Viewed by 3722

Abstract

Background: Obesity confers substantial cardiometabolic risk. Tirzepatide, a once-weekly dual GIP/GLP-1 receptor agonist, produces dose-dependent weight loss in trials, but real-world patient-reported experiences are under-described. We evaluated real-world self-efficacy and experiences with tirzepatide in community settings. Methods: Explanatory sequential mixed-methods study of adults aged 18–59 years using tirzepatide for weight management. We collected a quantitative survey (demographics; medication use; 20-item Weight Efficacy Lifestyle Questionnaire [WEL]) followed by purposive semi-structured interviews. Associations between WEL and participant characteristics were tested a priori (two-tailed α = 0.05). Results: Among 120 participants (50.8% male; mean age 42 ± 13 years), 91.7% reported weight loss and 85.8% had <6 months’ exposure. WEL total was 91 ± 34. Higher WEL was observed in females, employed participants, those with insurance coverage versus self-pay, during early months of therapy, and among those with prior weight-loss attempts (all p < 0.05). Interviews (n = 15) indicated high satisfaction, improved sleep/energy, mood, and confidence; gastrointestinal effects were usually mild/transient. Interpretation: In routine care, tirzepatide use was associated with high eating self-efficacy and positive patient-reported outcomes. Variation by coverage and duration suggests value in pairing pharmacotherapy with behavioral support and addressing affordability to sustain benefits. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

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11 pages, 471 KB

Open AccessArticle

Obesity, Knowledge, and Perceived Risk: Insights from the ObeCare Project Across Italian Territorial Pharmacies

by Francesco Ferro Russo, Federica Faccitondo, Vladimiro Grieco, Eugenio Leopardi, Stefania Agrimi, Gian Maria Rossi, Anna Cantarutti, Benedetta Canova, Riccardo Boracchini and Paolo Levantino

Healthcare 2025, 13(21), 2793; https://doi.org/10.3390/healthcare13212793 - 4 Nov 2025

Viewed by 1096

Abstract

Background: Obesity is a growing public health concern in Italy, with prevalence reaching 21.6% in 2022, particularly among the elderly. To address this issue, the ObeCare project was implemented to promote obesity prevention and awareness through community pharmacies. This study aimed to evaluate obesity-related knowledge, lifestyle behaviors, and risk perception among participants engaged in the ObeCare project. Methods: A survey was administered to individuals >18 years old across Italian pharmacies involved in the ObeCare initiative by trained pharmacists. A validated questionnaire assessed obesity-related knowledge, risk perception, lifestyle behaviors, demographics, clinical conditions, and Body Mass Index (BMI). A multinomial logistic regression was implemented to identify predictors of overweight and obesity. Results: Obesity was more prevalent among men, older adults, and those with multiple comorbidities. Healthier lifestyle and greater health knowledge were significantly associated with having a normal BMI, whereas low lifestyle scores (OR 13; 95% CI 2.96–57.85) and the presence of multiple comorbidities (OR 14.79; 95% CI 8.00–27.36) were strong predictors of obesity. Individuals with obesity exhibited lower knowledge (OR 1.55; 95% CI 1.02–2.37) and risk perception. Conclusions: This study highlights the significance of lifestyle habits, knowledge, and risk perception, which will be helpful in the prevention and management of obesity. These findings support community-based education and targeted interventions, especially for high-risk groups such as men, retirees, and residents of Southern Italy. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

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15 pages, 273 KB

Open AccessArticle

The Impact of Internet and Mobile Phone Usage and Unemployment on Adult Obesity: Empirical Evidence from the BRICS States

by Gamze Sart, Yilmaz Bayar, Marina Danilina and Marius Dan Gavriletea

Healthcare 2025, 13(21), 2765; https://doi.org/10.3390/healthcare13212765 - 30 Oct 2025

Viewed by 1399

Abstract

Background/Objectives: The number of overweight and obese people has significantly increased in the world, and this phenomenon is referred to as globesity. Globally increasing obesity has become one of the major problems to be dealt with for countries, given obesity-related health problems, including nutrition-related noncommunicable diseases and some types of cancer, and the economic and social costs of obesity. Therefore, countries try to combat obesity through diverse strategies related to nutrition, physical activity, and education. In this regard, identifying the factors behind obesity is critical to making progress in the fight against obesity. Methods: This study explores the interplay amongst ICT (information and communication technologies) indicators, including Internet and mobile phone usage, unemployment, and adult obesity in the BRICS states from 1995 to 2022, using recently developed cointegration techniques and causality tests. Results: The outcomes of causality tests uncover an interaction between Internet and mobile phone usage, unemployment, and adult obesity. In addition, the cointegration coefficients reveal that Internet and mobile phone usage positively impact adult obesity, while unemployment has a negative effect on adult obesity. Conclusions: Our outcomes uncover that improper use of the Internet and mobile phones foster adult obesity, but proper utilization of the Internet and mobile phones can be effective instruments in combatting adult obesity through increasing the awareness of healthy lifestyles and online weight loss programs. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

17 pages, 1275 KB

Open AccessArticle

Dietary Habits, TCM Constitutions, and Obesity: Investigating the Protective Effects of Vegetarian Dietary Patterns in Taiwan

by Po-Yu Huang, Chien-Hsiun Chen, Yen-Feng Chiu, Hong-Chun Lin and Ching-Mao Chang

Healthcare 2025, 13(14), 1641; https://doi.org/10.3390/healthcare13141641 - 8 Jul 2025

Cited by 1 | Viewed by 3398

Abstract

Background: Obesity is a global health challenge associated with metabolic and cardiovascular diseases. Traditional Chinese Medicine (TCM) body constitution theory offers a unique perspective on individual susceptibility to obesity; however, its integration into public health strategies remains underexplored. Objective: To examine the associations between vegetarian dietary patterns, TCM body constitution types (Phlegm stasis, Yang deficiency, and Yin deficiency), and overweight/obesity in a large-scale national cohort. Methods: Data were obtained from 3597 participants enrolled in the Taiwan Biobank. Socio-demographic variables, lifestyle behaviors (diet, smoking, physical activity), and anthropometric indicators (BMI and waist circumference) were assessed. Participants were categorized by weight status and TCM body constitution. Polytomous logistic regression models were used to evaluate associations between vegetarian dietary patterns, constitution types, and overweight/obesity, adjusting for potential confounders. Results: Among participants (mean age, 50.1 ± 9.4 years), 55.6% had normal BMI, 27.3% were overweight, and 17.1% were obese. Vegetarian dietary patterns were significantly associated with lower odds of Phlegm stasis (OR: 0.96; p < 0.001), Yang deficiency (OR: 0.97; p < 0.001), and Yin deficiency (OR: 0.97; p < 0.001), as well as with lower odds of overweight (OR: 0.72; p < 0.05) and obesity (OR: 0.67; p < 0.05). Physical activity was also associated with lower odds of all three constitution types and obesity. Phlegm stasis constitution was associated with higher odds of obesity (range of ORs: 1.18–1.58; p < 0.001). Conclusions: Vegetarian dietary patterns and regular physical activity were associated with lower odds of obesity and TCM constitution imbalances, particularly Phlegm stasis. These findings suggest a potential role for constitution-informed strategies in obesity-related public health approaches. Longitudinal studies are warranted to clarify temporal relationships and mechanisms. Clinical Trials Registration: ClinicalTrials.gov NCT03938207 (Study Start: 1 October 2022). Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

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11 pages, 451 KB

Open AccessArticle

Associations of Mentally Active Versus Passive Sedentary Behavior with Overweight/Obesity in Adults: Role of Patterns and Sex

by Daliya S. Alobaid and Abdullah B. Alansare

Healthcare 2025, 13(4), 361; https://doi.org/10.3390/healthcare13040361 - 8 Feb 2025

Cited by 2 | Viewed by 1867

Abstract

Objectives: This study assessed associations of total and mental-activity-based sedentary behavior (SB) with the risk of being overweight or obese in adults. The role of sex and SB patterns and the effects of statistically exchanging different mental-activity-based SBs on body mass index (BMI) were explored. Methods: Participants (n = 1154) from the Saudi Post-COVID-19 Sedentary Behavior Survey self-reported demographics, health-related variables, and last-measured body height and weight. BMI was calculated to classify adults as normal weight or overweight/obese. The Sedentary Behavior Questionnaire estimated total and mentally active and passive SB per day, during weekdays, and on weekends. Adjusted logistic regression and isotemporal substitution models assessed the associations of SBs with the risk of being overweight or obese and the effects of displacing mental-activity-based SBs on BMI, respectively. Results: No significant relationships were observed in the overall sample (p > 0.05). Once sex was considered, the risk of being overweight or obese increased between 5.2% and 10.7% for each hour increase in total and mentally active SBs per day and on weekends in men only (p < 0.05 for all). Replacing one hour of mentally active SB with mentally passive SB resulted in non-significant effects on BMI (p > 0.05). Conclusions: These findings reveal the importance of distinguishing between SBs based on mental activity for more optimal obesity outcomes, particularly in men. Importantly, exchanging mental-activity-based SBs does not appear to be an effective behavioral strategy to reduce obesity. Obesity prevention and management plans should target reducing total and mentally active SBs daily and on weekends. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

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Review

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28 pages, 434 KB

Open AccessReview

Endocrine and Metabolic Mechanisms Linking Obesity to Type 2 Diabetes: Implications for Targeted Therapy

by Salvatore Allocca, Antonietta Monda, Antonietta Messina, Maria Casillo, Walter Sapuppo, Vincenzo Monda, Rita Polito, Girolamo Di Maio, Marcellino Monda and Marco La Marra

Healthcare 2025, 13(12), 1437; https://doi.org/10.3390/healthcare13121437 - 16 Jun 2025

Cited by 16 | Viewed by 7722

Abstract

Obesity and Type 2 Diabetes Mellitus (T2DM) are interrelated chronic conditions whose global prevalence continues to rise, posing significant clinical and socioeconomic challenges. Their pathophysiological intersection—commonly referred to as “diabesity”—is sustained by a complex interplay of mechanisms, including visceral adipose tissue inflammation, macrophage polarization, disrupted insulin signaling, and adipokine imbalance. These processes contribute to chronic low-grade systemic inflammation, impair pancreatic β-cell function, and exacerbate glucose intolerance. This review critically explores the mechanistic connections between obesity and T2DM, with a focus on recent advances in pharmacological therapies—such as GLP-1 receptor agonists, SGLT2 inhibitors, and dual GIP/GLP-1 receptor agonists—alongside evidence-based lifestyle modifications and bariatric procedures. By integrating current translational and clinical findings, we aim to provide a comprehensive perspective to support the development of more effective and individualized treatment strategies for diabesity. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

Other

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16 pages, 1650 KB

Open AccessSystematic Review

A Systematic Review and Meta-Analysis of the Effects of Various Physical Activity Interventions in Pregnant Women with Overweight or Obesity

by Mingmao Li, Hongli Yu, Guoping Qian, Anna Szumilewicz and Zbigniew Ossowski

Healthcare 2025, 13(24), 3319; https://doi.org/10.3390/healthcare13243319 - 18 Dec 2025

Viewed by 1158

Abstract

Background: Obesity during pregnancy increases the risk of adverse maternal and neonatal outcomes, and excessive gestational weight gain (GWG) remains highly prevalent worldwide. Although physical activity (PA) interventions have shown potential benefits, evidence on the optimal type, intensity, and duration of exercise for overweight or obese pregnant women remains limited. Methods: Electronic searches of EBSCOhost, Embase, PubMed and Web of Science were performed through August 2025 to identify randomized controlled trials comparing PA interventions versus usual prenatal care in overweight or obese pregnant women. Two reviewers independently screened studies, extracted data, and assessed risk of bias using Cochrane ROB domains. Continuous outcomes were pooled using inverse-variance meta-analytic methods and heterogeneity was quantified by I². Results: Ten randomized trials (twelve intervention arms) comprising 1150 participants met the inclusion criteria. In the domain of blinding of participants and personnel, three studies (30%) were judged as low risk, while seven (70%) were unclear. PA interventions varied in modality (aerobic, resistance, endurance, walking), setting (clinic, community, home/mHealth), and the intervention period ranges from 10 to 34 weeks. Most interventions (80%) employed moderate intensity, and 30% combined aerobic and resistance training. Results of the meta-analysis showed that the pooled mean GWG was 9.93 ± 5.48 kg in the treatment group and 10.65 ± 5.70 kg in the control group. Overall, PA interventions produced a modest but statistically significant reduction in GWG compared with controls, with negligible between-study heterogeneity (I² = 0%). Conclusions: Tailored, moderate-intensity PA may have the potential to modestly reduce GWG. Although 30% included trials employed combined aerobic and resistance training, current evidence is insufficient to establish whether combined modalities are more effective than aerobic-only or resistance-only interventions. However, the current evidence is limited by small trial sizes, methodological variability and geographic concentration in higher-income settings. Larger, rigorously designed RCTs, including evaluations of digital delivery platforms and carefully supervised higher-intensity protocols, are needed to refine exercise prescriptions and inform clinical guidelines. Full article

(This article belongs to the Special Issue Obesity and Overweight: Prevention, Causes and Treatment)

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