Obesity: Precision Diagnosis, Personalised Treatment, Patient Engagement and Recognition as a Disease

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 8987

Special Issue Editor


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Guest Editor
Precision Health Department, Luxembourg Institute of Health, Strassen, Luxembourg
Interests: obesity; body composition; visceral adiposity

Special Issue Information

Dear Colleagues,

Evidence has shown that obesity is a chronic multifactorial relapsing disease due to several internal and external factors, and a significant gene–environment interaction. Obesity is a global public health challenge, given its pandemic spread and associated comorbidities.

Beyond corpulence assessment using body mass index (BMI), the characterisation of obesity has evolved to take into consideration visceral adipose tissue (VAT) storage, a major independent risk factor for several cardiometabolic, autoimmune, neurodegenerative and oncological diseases and premature mortality. Furthermore, the Edmonton Obesity Staging System enables researchers to rank obesity severity based on the assessment of the metabolic, mechanical and psychological comorbidities associated with obesity and quality of life.

In addition, a clear paradigm shift has occurred, changing from the ‘eat less and move more’ message, to more personalized and evidence-based treatments, i.e., cognitive behavioural therapy, pharmacotherapy and bariatric surgery. The role played by the environmental exposure was highlighted as a key element of innovative prevention strategies. A patient-centred approach was recommended to understand the patient lived experience and promote shared decision-making.
Nevertheless, despite the evidence, most of countries still do not recognise obesity as a disease that requires personalised care and innovative prevention strategies, nor do they recognise the role played by patient insight in the therapeutic process.

The non-recognition of obesity as a disease results in a significant burden of stigma towards people living with obesity, leading to inadequate care and poor health.

This Special Issue is dedicated to the recent advancements in favour of the recognition of obesity as a disease and should be of interest to healthcare professionals, policymakers, people living with obesity and scientists. The scope of the Special Issue covers obesity diagnosis, treatment and prevention, patient engagement and health policies.
Specific areas of interest include, but are not limited to, obesity definition, assessment, causes and contributors, body composition, cognitive behavioural therapy, pharmacotherapy, bariatric and metabolic surgery, innovative prevention strategies.

We welcome contributions from researchers, clinicians, healthcare professionals, people and patients living with obesity, policymakers, and all professionals interested in the field.

The European Association for the Study of Obesity (https://easo.org/), the leading voice of obesity science, medicine, and community in Europe, representing scientists, obesity specialists, physicians, healthcare practitioners, public health practitioners, and patients, is supporting the Special Issue with the editorial foreword.

Dr. Hanen Samouda
Guest Editor

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Keywords

  •  obesity policies
  •  adipose tissue
  •  body composition
  •  patient advocacy
  •  weight bias
  •  genetics
  •  physical pain
  •  hormonal appetite dysregulation
  •  eating disorders
  •  trauma
  •  mental health
  •  environmental exposure
  •  food exposure
  •  market economy
  •  sedentary work
  •  family conflict

Published Papers (5 papers)

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Research

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16 pages, 325 KiB  
Article
Blood Concentration of Macro- and Microelements in Women Who Are Overweight/Obesity and Their Associations with Serum Biochemistry
by Zuzana Knazicka, Maros Bihari, Ivona Janco, Lubos Harangozo, Julius Arvay, Anton Kovacik, Peter Massanyi, Branislav Galik, Jorge M. A. Saraiva and Marta Habanova
Life 2024, 14(4), 465; https://doi.org/10.3390/life14040465 - 02 Apr 2024
Viewed by 522
Abstract
Risk elements in blood matrices can affect human health status through associations with biomarkers at multiple levels. The aim of this study was to analyze 15 macro- and microelements in the blood serum of women with overweight (BMI of ≥25 kg/m2) [...] Read more.
Risk elements in blood matrices can affect human health status through associations with biomarkers at multiple levels. The aim of this study was to analyze 15 macro- and microelements in the blood serum of women with overweight (BMI of ≥25 kg/m2) and obesity (BMI of ≥30 kg/m2) and to examine possible associations with biochemical, liver enzymatic parameters, and markers of oxidative stress. Based on the power calculation, the study involved women (in the postmenopausal stage) with overweight (n = 26) and obesity (n = 22), aged between 50–65 years. Multifrequency bioelectrical impedance analysis was used to measure body composition parameters. Concentrations of elements were determined by inductively coupled plasma optical emission spectrometry, and Hg was measured using cold-vapor atomic absorption spectroscopy. Individuals with obesity, as indicated by a higher BMI, percentage of body fat, and visceral fat area, had elevated serum levels of Ca, Mg, Fe, Al, Sr, Pb, and Hg. Concentrations of Al, Cu, K, Sb, Zn, and Pb significantly affected biochemical and liver function markers in women with overweight or obesity. Elements such as Cu and Al were associated with increased total cholesterol. The correlation analysis between total antioxidant status and Cu, Al, and Ni confirmed associations in both groups. Our findings underscore the importance of addressing excess body weight and obesity in relation to risk elements. The results of the research could be beneficial in identifying potential targets for the treatment or prevention of comorbidities in people with obesity. Full article
14 pages, 1915 KiB  
Article
A Federated Database for Obesity Research: An IMI-SOPHIA Study
by Carl Delfin, Iulian Dragan, Dmitry Kuznetsov, Juan Fernandez Tajes, Femke Smit, Daniel E. Coral, Ali Farzaneh, André Haugg, Andreas Hungele, Anne Niknejad, Christopher Hall, Daan Jacobs, Diana Marek, Diane P. Fraser, Dorothee Thuillier, Fariba Ahmadizar, Florence Mehl, Francois Pattou, Frederic Burdet, Gareth Hawkes, Ilja C. W. Arts, Jordi Blanch, Johan Van Soest, José-Manuel Fernández-Real, Juergen Boehl, Katharina Fink, Marleen M. J. van Greevenbroek, Maryam Kavousi, Michiel Minten, Nicole Prinz, Niels Ipsen, Paul W. Franks, Rafael Ramos, Reinhard W. Holl, Scott Horban, Talita Duarte-Salles, Van Du T. Tran, Violeta Raverdy, Yenny Leal, Adam Lenart, Ewan Pearson, Thomas Sparsø, Giuseppe N. Giordano, Vassilios Ioannidis, Keng Soh, Timothy M. Frayling, Carel W. Le Roux and Mark Ibbersonadd Show full author list remove Hide full author list
Life 2024, 14(2), 262; https://doi.org/10.3390/life14020262 - 16 Feb 2024
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Abstract
Obesity is considered by many as a lifestyle choice rather than a chronic progressive disease. The Innovative Medicines Initiative (IMI) SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) project is part of a momentum shift aiming to provide better tools for [...] Read more.
Obesity is considered by many as a lifestyle choice rather than a chronic progressive disease. The Innovative Medicines Initiative (IMI) SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) project is part of a momentum shift aiming to provide better tools for the stratification of people with obesity according to disease risk and treatment response. One of the challenges to achieving these goals is that many clinical cohorts are siloed, limiting the potential of combined data for biomarker discovery. In SOPHIA, we have addressed this challenge by setting up a federated database building on open-source DataSHIELD technology. The database currently federates 16 cohorts that are accessible via a central gateway. The database is multi-modal, including research studies, clinical trials, and routine health data, and is accessed using the R statistical programming environment where statistical and machine learning analyses can be performed at a distance without any disclosure of patient-level data. We demonstrate the use of the database by providing a proof-of-concept analysis, performing a federated linear model of BMI and systolic blood pressure, pooling all data from 16 studies virtually without any analyst seeing individual patient-level data. This analysis provided similar point estimates compared to a meta-analysis of the 16 individual studies. Our approach provides a benchmark for reproducible, safe federated analyses across multiple study types provided by multiple stakeholders. Full article
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9 pages, 575 KiB  
Communication
Association between Sarcopenia and Reduced Bone Mass: Is Osteosarcopenic Obesity a New Phenotype to Consider in Weight Management Settings?
by Antonino De Lorenzo, Leila Itani, Paola Gualtieri, Massimo Pellegrini, Marwan El Ghoch and Laura Di Renzo
Life 2024, 14(1), 21; https://doi.org/10.3390/life14010021 - 21 Dec 2023
Viewed by 982
Abstract
Sarcopenic obesity (SO) is a frequent phenotype in people with obesity; however, it is unclear whether this links with an impaired bone status. In this study, we aimed to investigate the association between SO and low bone mass, and to assess the prevalence [...] Read more.
Sarcopenic obesity (SO) is a frequent phenotype in people with obesity; however, it is unclear whether this links with an impaired bone status. In this study, we aimed to investigate the association between SO and low bone mass, and to assess the prevalence of a new entity that combines excessive fat deposition, reduced muscle mass and strength, and low bone mass defined as osteosarcopenic obesity (OSO). Body composition was completed by a DXA scan in 2604 participants with obesity that were categorized as with or without SO, and with low or normal bone mineral content (BMC). Participants with both SO and low BMC were defined as OSO. Among the entire sample, 901 (34.6%) participants met the criteria for SO. This group showed a reduced mean BMC (2.56 ± 0.46 vs. 2.85 ± 0.57, p < 0.01) and displayed a higher prevalence of individuals with low BMC with respect to those without SO (47.3% vs. 25.9%, p < 0.01). Logistic regression analysis showed that the presence of SO increases the odds of having low BMC by 92% [OR = 1.92; 95% CI: (1.60–2.31), p < 0.05] after adjusting for age, body weight, and body fat percentage. Finally, 426 (16.4%) out of the total sample were affected by OSO. Our findings revealed a strong association between SO and reduced bone mass in adults with obesity, and this introduces a new phenotype that combines body fat, muscle, and bone (i.e., OSO) and appears to affect 16% of this population. Full article
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Review

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15 pages, 279 KiB  
Review
Optimizing Childhood Obesity Management: The Role of Edmonton Obesity Staging System in Personalized Care Pathways
by Astrid De Wolf, Elise Nauwynck, Jesse Vanbesien, Willem Staels, Jean De Schepper and Inge Gies
Life 2024, 14(3), 319; https://doi.org/10.3390/life14030319 - 28 Feb 2024
Viewed by 839
Abstract
Childhood obesity, affecting 29% of 7–9-year-olds across 33 European countries, is a significant public health challenge. Its persistence into adulthood poses grave health risks influenced by genetic, environmental, and socio-economic factors. Belgium introduced a new care pathway in December 2023, based on the [...] Read more.
Childhood obesity, affecting 29% of 7–9-year-olds across 33 European countries, is a significant public health challenge. Its persistence into adulthood poses grave health risks influenced by genetic, environmental, and socio-economic factors. Belgium introduced a new care pathway in December 2023, based on the Edmonton Obesity Staging System for Pediatrics (EOSS-P), addressing four health domains and staging obesity severity. This pathway operates across three levels: primary care physicians, Paediatric Multidisciplinary Obesity Management Centres (PMOCs), and Centers of Expertise for Paediatric Obesity Management (CEPOs). Each stage of EOSS-P demands tailored interventions. Early stages involve dietary interventions, physical activity promotion, and behavior modifications. As obesity severity progresses, treatments intensify, encompassing psychological support, anti-obesity medications, and, in some cases, bariatric surgery. Throughout these stages, the involvement of multidisciplinary teams is crucial, emphasizing family-based approaches and continuous monitoring. This article provides detailed guidelines for healthcare professionals, delineating interventions and recommendations tailored to each EOSS-P stage. It emphasizes a holistic approach that extends beyond BMI-based diagnosis, promoting personalized care and prompt escalations between care levels, thereby ensuring optimal management of childhood obesity. This comprehensive framework aims to address the complexities of childhood obesity, emphasizing the importance of timely and targeted interventions for better health outcomes. Full article
18 pages, 655 KiB  
Review
Pediatric Obesity: Complications and Current Day Management
by Mary Ellen Vajravelu, Emir Tas and Silva Arslanian
Life 2023, 13(7), 1591; https://doi.org/10.3390/life13071591 - 20 Jul 2023
Cited by 2 | Viewed by 4014
Abstract
Obesity affects approximately 1 in 5 youth globally and increases the risk of complications during adolescence and young adulthood, including type 2 diabetes, dyslipidemia, hypertension, non-alcoholic fatty liver disease, obstructive sleep apnea, and polycystic ovary syndrome. Children and adolescents with obesity frequently experience [...] Read more.
Obesity affects approximately 1 in 5 youth globally and increases the risk of complications during adolescence and young adulthood, including type 2 diabetes, dyslipidemia, hypertension, non-alcoholic fatty liver disease, obstructive sleep apnea, and polycystic ovary syndrome. Children and adolescents with obesity frequently experience weight stigma and have an impaired quality of life, which may exacerbate weight gain. Pediatric obesity is typically defined using sex-, age-, and population-specific body mass index percentiles. Once identified, pediatric obesity should always be managed with lifestyle modification. However, adolescents with obesity may also benefit from anti-obesity medications (AOM), several of which have been approved for use in adolescents by the US Food and Drug Administration, including liraglutide, phentermine/topiramate, and semaglutide. For children with specific, rare monogenic obesity disorders, setmelanotide is available and may lead to significant weight loss. Metabolic and bariatric surgery may be used for the management of severe obesity in youth; though highly effective, it is limited to specialized centers and has had relatively low pediatric uptake. In this narrative review using pediatric-focused data from original research, reviews, clinical practice guidelines, governmental agencies, and pharmaceutical companies, we review obesity-related metabolic complications in youth and management strategies, including AOM and bariatric surgery. Full article
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