Pathophysiology and Treatments of Obesity

Dear Colleagues,

Obesity is widely recognized as a complex, chronic, and relapsing disease driven by a multifactorial etiology that encompasses genetic, environmental, and physiological factors. Despite public health efforts, the global prevalence of obesity continues to rise, bringing with it a significant burden of comorbidities, including type 2 diabetes, cardiovascular disease, and metabolic dysfunction-associated steatotic liver disease (MASLD). In recent years, our understanding of the pathophysiological mechanisms underlying energy homeostasis—such as the gut–brain axis, adipose tissue inflammation, and hormonal regulation—has greatly expanded. This has paved the way for a paradigm shift in treatment. We are moving beyond lifestyle interventions alone toward highly effective biological therapies, specifically metabolic surgery and next-generation pharmacological agents.

We are pleased to invite you to contribute to this Special Issue, which seeks to document the rapid evolution of these therapeutic landscapes.

This Special Issue aims to bridge the gap between basic pathophysiological research and clinical application. We seek to highlight how a deeper understanding of molecular and metabolic pathways is translating into more effective surgical and pharmacological treatments. Specifically, this Special Issue focuses on the comparative effectiveness, mechanisms of action, and long-term outcomes of bariatric surgery versus emerging anti-obesity medications (such as GLP-1 and dual/triple agonists).

By integrating these two pillars of treatment, this Special Issue falls within the journal's scope of advancing clinical knowledge and therapeutic strategies for metabolic disorders. It will serve as a platform for discussing the future of personalized obesity management.

In this Special Issue, original research articles and comprehensive reviews are welcome. We also encourage meta-analyses and short communications. Research areas may include (but are not limited to) the following:

• Mechanisms of Action: The role of gut hormones (GLP-1, GIP, PYY) in weight loss following metabolic surgery vs. pharmacotherapy.
• Novel Pharmacotherapy: Efficacy and safety of incretin-based therapies (e.g., semaglutide, tirzepatide, retatrutide) and other emerging anti-obesity drugs.
• Combination Strategies: The use of anti-obesity medications as adjuvant therapy before or after bariatric surgery to prevent weight regain or address insufficient weight loss.
• Pathophysiology: The impact of treatments on adipose tissue dysfunction, chronic low-grade inflammation, and the gut microbiome.
• Comorbidity Resolution: Remission of type 2 diabetes and cardiovascular risk reduction through surgical or pharmacological means.
• Precision Medicine: Predictors of response to surgery or medication based on genetic or phenotypic profiles.

We look forward to receiving your contributions.

Dr. Francesco Saverio Latteri
Dr. Andrea Peri
Dr. Marcello Agosta
Guest Editors

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 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.