Obesities

Obesity is ranked as one of the biggest health challenges facing humanity today. Globally, the number of obese people has almost tripled since 1975, and this lifestyle disease currently affects hundreds of millions of adults who suffer from major health problems due to it, such as heart disease, type 2 diabetes and some cancers, that weigh heavily on the global health systems, In order to keep high standards for methods, anthropometric variables, i.e., Height and Weight have been intentionally excluded from the features, because labels for obesity classes are based on these measurements; thus, including them would introduce target leakage. All models were individually tuned with Optuna (50 trials, TPE sampler), and the class imbalance was managed by the synthetic minority over-sampling technique (SMOTE), which was done only in training folds. The models were evaluated by stratified five-fold cross-validation, with the macro-averaged F1-score being used as the main metric for evaluation. The best model was the fine-tuned XGBoost, which gave a test macro F1-score value of 0.872 and a macro-AUC of 0.977. The model was higher performing than others such as Random Forest (F1 = 0.869), MLP (F1 = 0.777), and Logistic Regression (F1 = 0.605). This means that behavioral and lifestyle variables may have a very strong and sufficient signal to identify obesity status, even when there are no direct anthropometric measurements available. However, it is worth noting that results here represent only performance on a single public benchmark dataset, so they cannot be taken as proof that the model would do well in real-world clinical settings. With the advent of ML methods for obesity prediction, rigorous, leakage-free evaluation becomes indispensable. Apart from external validation of the clinical models on independent datasets, the use of interpretability tools such as SHapley Additive exPlanations (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME) for understanding decision-making, as well as sex and gender subgroup analyses for evaluating fairness and equity, should also be pursued in the future. This study highlights the importance of rigorous, leakage-free evaluation in machine learning-based obesity research. Future work should focus on external validation using independent clinical cohorts, the integration of interpretability techniques such as SHapley Additive exPlanations (SHAP) and Local Interpretable Model-Agnostic Explanations (LIME), and subgroup analyses by sex and gender to assess model fairness and clinical equity. Full article

Background: Overweight and obesity remain major public health challenges in Puerto Rico, affecting over 70% of adults and contributing to cardiovascular, metabolic, and mental health disorders. This study explores the psychosocial and behavioral factors influencing obesity within low-income Puerto Rican communities, emphasizing both biological sex differences and socially defined sex-role influences, along with their respective mental health dimensions. Method: Using a qualitative approach, Community-Based Participatory Research (CBPR), ten focus groups were conducted with 71 participants (37 women and 34 men) from two municipalities in southern Puerto Rico. Discussions were analyzed thematically with the Socioecological and Health Belief Models to identify key determinants. Results: The data collected revealed that women expressed greater emotional vulnerability, frequently citing anxiety, depression, body image concerns, and stress-related eating as contributors to obesity. Men, meanwhile, reported frustration with diet adherence, economic limitations, and healthcare inaccessibility. Across participants, economic hardship, cultural norms, and limited health education emerged as major obstacles. Conclusions: Findings underscore the need for holistic, sex-informed and socially responsive interventions that integrate mental health support with nutritional and physical health strategies. Addressing self-esteem, emotional regulation, and stress management alongside behavioral modification can promote sustainable, culturally tailored obesity prevention in Puerto Rico. Full article

Background: School feeding programs aim to improve child nutrition, and they may influence weight outcomes insofar as program modalities and household responses alter children’s total energy intake. This is especially relevant in countries facing the double burden of malnutrition, where undernutrition and micronutrient deficiencies coexist with rising overweight and obesity. This study estimates the effect of Peru’s former National School Feeding Program on obesity and excess weight among children aged 36 to 59 months under a selection-on-observables identification strategy and assesses whether impacts differ across operational modalities, particularly breakfast-only versus breakfast plus lunch and ready-to-eat rations versus foods delivered for preparation. Methods: We use repeated cross-sectional microdata from the Demographic and Health Survey (ENDES) pooled over 2014 to 2018 and link them to administrative information. The sample includes 18,959 children aged 36 to 59 months. To improve comparability, we estimate propensity score weights targeting the average treatment effect on the treated (ATT) using a machine learning generalized boosted model (GBM), and assess covariate balance using standardized mean differences and Kolmogorov–Smirnov statistics. Identification assumes conditional independence given observed covariates and overlap (common support). Main estimates rely on weighted probit models with fixed effects, progressively adding exposure duration, modality indicators, and controls. Distributional effects are examined using quantile regression on the continuous weight-for-height z-score. Results: Without differentiating modalities, beneficiary status is not associated with a statistically significant change in obesity, while pooled baseline estimates indicate a statistically significant higher probability of excess weight. Modality-specific results show that obesity declines only when Qali Warma is delivered as breakfast plus lunch through products to be prepared (approximately −1.0 percentage point in parsimonious models and −0.4 percentage points after controls). Evidence for excess weight is directionally consistent by modality but less conclusive once controls are included. Conclusions: Qali Warma’s effects on early-childhood weight outcomes depend on implementation modality. Evaluations of school feeding programs should incorporate operational heterogeneity, particularly during program redesign. Full article

Background: Male college students are at risk for weight gain due to unhealthy dietary habits. This study assessed the dietary habits of undergraduate college males. Methods: Online cross-sectional survey (n = 235) of randomly sampled male undergraduate college students. Results: The mean age was 21.15 ± 3.21. Most were enrolled full-time (91.5%), lived off-campus (77.4%), upper class (59.6%), had a campus meal plan (52.8%), and white (51.9%). Mean body mass index (BMI) was 25.02 ± 4.86. Males gained an average of 10.81 ± 13.01 lbs while in college. Most ate one to two servings of fruits (67.1%) and vegetables (65.1%). Significant differences in weight gained during college and fruit consumed was significant [p = 0.02 *]. Male students reported on 20 different foods and drinks they consumed at least “a few times per week.” Most ate fresh fruits (76.1%), prepared a hot meal at home (72.7%), ate fresh vegetables (68.1%). Males also ate at fast-food restaurants (47.7%) and drank coffee (44.4%). Males that reported they drank alcohol (p = 0.03*), diet soda (p = 0.03 *), coffee (p = 0.01 *), and ate at fast-food restaurants (p = 0.02 *) “a few times per week” were found to have significantly gained more weight. Conclusions: Increased intake and consumption of alcohol, diet soda, and fast-food was associated with increased weight gain among college males. Full article

Low levels of physical activity and prolonged sedentary behavior among young people are important contributors to the growing prevalence of overweight and obesity worldwide. Because children and adolescents spend a large proportion of their waking hours in school environments that often involve extended periods of sitting, schools represent a strategic setting for interventions aimed at promoting healthier movement behaviors and lifestyle habits. Classroom-based active breaks, defined as short bouts of physical activity integrated into regular lessons, have been proposed as a practical and scalable strategy to interrupt sedentary time without substantially disrupting academic instruction. This narrative review examines how active breaks have been implemented in school settings and synthesizes current evidence regarding their effects on physical activity, sedentary behavior, lifestyle-related outcomes, and obesity-related indicators among children and adolescents. Relevant literature published since 2006 was identified through searches of PubMed, Scopus, and Web of Science. The available evidence suggests that active breaks can increase in-school physical activity and reduce prolonged sedentary exposure, while also contributing to improvements in classroom behavior, cognitive engagement, and several lifestyle-related and psychosocial outcomes. However, direct effects on adiposity indicators appear modest and are often difficult to isolate because active breaks are frequently implemented within broader school-based health interventions. Overall, active breaks represent a feasible and low-cost strategy that may support healthier lifestyle behaviors and contribute to obesity prevention when regularly integrated into school routines. Full article

Background: Serum uric acid (SUA) has emerged as a relevant cardiometabolic and hepatic risk marker in adolescents with obesity. Cinnamon has shown metabolic benefits in adults; however, its effects on SUA and hepatic markers in pediatric populations remain unclear. This study aimed to evaluate the efficacy of cinnamon supplementation on serum uric acid, hepatic enzymes, and lipid profiles in adolescents with obesity. Methods: This is a secondary analysis of a randomized, double-blind, placebo-controlled clinical trial including 93 adolescents (10–18 years) with obesity (BMI ≥ 95th percentile). Participants received either 3 g/day of Cinnamomum verum or a placebo for 16 weeks, alongside lifestyle intervention. Changes in BMI z-score, SUA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and triglycerides were analyzed. Results: The cinnamon group showed a greater reduction in BMI z-score compared to placebo (Δ −0.08 vs. −0.02; p < 0.001). Serum uric acid decreased significantly in the cinnamon group (median change: −0.5 mg/dL [IQR: −1.0 to −0.2]) compared to placebo (−0.1 mg/dL [IQR: −0.4 to 0.2]; p < 0.01). Triglycerides also decreased in the cinnamon group (−18 mg/dL [IQR: −35 to −5]) versus placebo (−5 mg/dL [IQR: −20 to 10]; p < 0.05). Hepatic enzymes (ALT, AST, and GGT) decreased significantly within both groups, without significant differences between groups. In a subgroup of participants with elevated baseline ALT (n = 67), ALT decreased in both groups (placebo: 32.0 to 30.0 U/L, p = 0.004; cinnamon: 33.0 to 26.0 U/L, p = 0.001), with a greater but non-significant reduction in the cinnamon group (Δ −6.0 vs. −2.0 U/L; p = 0.197). Conclusions: Cinnamon supplementation significantly reduced serum uric acid and improved metabolic parameters in adolescents with obesity. These findings suggest that cinnamon may act as an adjunct strategy targeting early cardiometabolic risk markers, particularly uric acid. Full article

Background: Obesity remains a major public health challenge, with central and visceral fat distribution conferring particularly high cardiometabolic risk. Lifestyle factors, including diet, physical activity, and sleep quality, have been implicated in adiposity, yet their combined and interactive effects in working populations remain insufficiently characterized. Methods: We conducted a cross-sectional study in 88,343 Spanish employees (53,122 men, 35,221 women) attending occupational health examinations between 2021 and 2024. Obesity was assessed using four complementary indices: body mass index (BMI), waist-to-height ratio (WHtR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Lifestyle factors included sleep quality (Pittsburgh Sleep Quality Index), Mediterranean diet adherence (MEDAS), and physical activity (IPAQ). Multivariable logistic regression models were adjusted for sociodemographic and lifestyle variables, with interaction, stratified, joint exposure, and dose–response analyses. Results: Obesity prevalence varied widely by index, ranging from 18.9% (BMI) to 55.6% (CUN-BAE). Poor sleep quality was independently associated with higher odds of obesity across all indices, particularly central obesity (WHtR OR 1.58, 95% CI 1.48–1.69), with stronger associations observed in women. Physical inactivity and non-adherence to the Mediterranean diet were robust predictors, with inactivity showing the largest effect sizes (METS-VF OR 9.92, 95% CI 8.70–11.15). Interaction analyses indicated that both Mediterranean diet adherence and regular physical activity attenuated the adverse association between poor sleep and obesity outcomes. Restricted cubic spline models revealed a progressive dose–response relationship between increasing PSQI score and central obesity. Joint exposure analyses showed nearly five-fold higher odds of central obesity among workers with concurrent poor sleep, physical inactivity, and low Mediterranean diet adherence. A graded inverse association was observed between a composite healthy lifestyle score (0–3) and obesity, with a score of 3 associated with 72–75% lower odds of BMI-obesity and WHtR-high. Conclusions: In this large occupational cohort, poor sleep quality, physical inactivity, and low Mediterranean diet adherence emerged as independent and combined determinants of general, central, and visceral obesity. Integrated workplace strategies promoting sleep hygiene, physical activity, and dietary quality—particularly among women and lower socioeconomic groups—may represent an effective approach to reducing obesity risk in working populations. Full article

Concerns about weight gain are commonly cited with combined oral contraceptive pill (COCP) use, yet it remains unclear whether perceived weight gain as a reason for discontinuation differs by body mass index (BMI). We analyzed data from the 2017–2019 National Survey of Family Growth (NSFG), including 3709 non-pregnant women aged 20–49 years who had ever used COCPs and had BMI calculated from self-reported height and weight. Trained NSFG staff interviewed participants on reasons for discontinuation and coded them into predefined categories, including weight gain. Discontinuation was examined by BMI category (underweight, normal weight, overweight, obesity) using survey-weighted logistic regression adjusted for demographic and socioeconomic covariates. Overall, 35.2% (95% CI 32.3–38.1%) of women reported discontinuing COCPs due to dissatisfaction, with 20.2% (95% CI 18.1–22.3%) citing side effects. Weight gain was reported by 7.0% (95% CI 5.6–8.4%) of ever-users, with higher prevalence among women with overweight (8.4%) and obesity (7.7%) compared with normal-weight women (5.5%). In adjusted analyses, women with overweight (aOR 1.76, p = 0.048) and obesity (aOR 1.68, p = 0.033) had higher odds of COCP discontinuation due to self-reported weight gain. These findings highlight the importance of addressing weight-related concerns during contraceptive counseling, particularly for women with higher BMI. Full article

This review examines the current state of development and application of artificial intelligence (AI) tools for monitoring nutrition and physical activity in individuals with obesity, with a focus on the physiological complexity of energy balance and the role of chrono-nutrition. Energy intake and expenditure are dynamically coupled and circadian-regulated: meal timing and movement patterns influence insulin sensitivity, thermogenesis, and Non-Exercise Activity Thermogenesis within the same day. Traditional monitoring methods suffer from recall bias and low granularity, while isolated sensors operate in data silos, limiting accuracy. Effective solutions require multimodal, continuous, and temporally aligned data streams. Current AI models exhibit critical limitations in obesity-specific contexts: inaccurate gait and energy expenditure estimates due to biomechanical differences, dietary models underestimating glycemic variability, poor performance on mixed dishes, sauces, and culturally diverse foods, and a lack of validation against gold standards such as doubly labelled water (DLW) and weighed food records. This review proposes a paradigm shift toward obesity-specific AI design, including enriched datasets and multimodal integration. Physical activity monitoring faces similar challenges: systematic measurement bias in wearables, sensor placement issues, and algorithms trained on normal-weight cohorts. In the GLP-1/GIP era, if transparency, ethical safeguards, and equitable access are ensured, AI will act as a catalyst for personalized care, remote monitoring, trial optimization, and next-generation drug discovery. In conclusion, the integration of AI with rigorous validation procedures and inclusive sampling strategies is essential to achieve reliable, fair, and clinically relevant monitoring approaches for obesity management. Full article

Nutraceuticals are bioactive compounds with potential roles in disease prevention and treatment. Their accessibility and affordability have driven growing interest in obesity care. Among them, bioactive hydrolysates derived from Saccharomyces cerevisiae show promise, yet clinical guidelines seldom address their use. We aimed to develop a guidance statement on their appropriateness using the RAND/UCLA consensus method. A multidisciplinary panel of ten experts rated the appropriateness of a bioactive hydrolysate derived from Saccharomyces cerevisiae across clinical scenarios relevant to obesity care, informed by a targeted evidence review and conducted using the two-round RAND/UCLA consensus method, with ratings on a 1–9 scale. The panel deemed the use of the bioactive hydrolysate derived from Saccharomyces cerevisiae, in combination with lifestyle modifications, as an appropriate intervention for managing obesity-related outcomes. This included its use in patients with specific comorbidities, as an adjunct to standard pharmacotherapy, and in a set of selected clinical scenarios. Based on evidence and expert consensus, a bioactive hydrolysate derived from Saccharomyces cerevisiae is appropriate across a range of clinical scenarios within comprehensive obesity care. Further studies should evaluate long-term effectiveness, broader populations and combination regimens. Full article

Background: Overweight and obesity are emerging public health concerns among young adults. However, evidence on associated sociodemographic, dietary, and lifestyle factors among young industrial workers in low- and middle-income countries remains limited. This study aimed to identify factors associated with overweight and obesity among Vietnamese young industrial workers aged 18–30 years. Methods: A cross-sectional study was conducted among 2295 young industrial workers (55.6% men and 44.4% women) recruited from factories and industrial zones in three geographic regions of Vietnam. Sociodemographic characteristics, dietary habits, lifestyle behaviors, and physical activity were assessed using a structured questionnaire. Body mass index (BMI) was calculated from self-reported height and weight and classified using WHO Western Pacific Region (WPRO) cut-offs; overweight/obesity was defined as BMI ≥ 23.0 kg/m². Physical activity was assessed using the International Physical Activity Questionnaire—Long Form (IPAQ-LF) and categorized by total MET-min/week according to IPAQ scoring guidelines. Logistic regression analyses were performed to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results: Overall, 10.4% of participants were overweight (BMI 23.0–24.9 kg/m²) and 7.0% were obese (BMI ≥ 25.0 kg/m²), yielding a combined prevalence of 17.4%. After multivariable adjustment, increasing age (aOR = 1.15; 95% CI: 1.10–1.20), male sex (aOR = 2.10; 95% CI: 1.59–2.76), and regular alcohol consumption (aOR = 1.37; 95% CI: 1.04–1.81) were independently associated with higher odds of overweight/obesity, while residence in the Southern region was inversely associated (aOR = 0.57; 95% CI: 0.42–0.76). High total physical activity (vs. low activity) was positively associated with overweight/obesity, whereas moderate physical activity was not independently associated. Other dietary behaviors were not significantly associated after adjustment. Conclusions: Among Vietnamese young industrial workers, overweight and obesity were associated with age, sex, alcohol consumption, and geographic region. The observed association with high total physical activity likely reflects the occupational context of physical activity in this population, highlighting the importance of distinguishing between occupational and leisure time physical activity when interpreting physical activity obesity relationships. These findings underscore the relevance of early, workplace relevant prevention strategies targeting modifiable behaviors, particularly alcohol use. Full article

Background: Cardiovascular risk factors may emerge early in life and track into adulthood. Local data from inland and socioeconomically vulnerable regions remain limited. This study aimed to describe cardiovascular risk indicators in school-aged children from inland Portugal, focusing on body mass index (BMI), blood pressure (BP), and physical activity patterns. Methods: A cross-sectional school-based screening study was conducted in 101 children and adolescents aged 10–15 years. Anthropometric measurements and BP were obtained using standardized procedures. BMI categories were classified according to age- and sex-specific WHO references. BP was classified using European pediatric percentiles. Because measurements were obtained during a single visit, results were interpreted as elevated BP at screening. Associations between variables were explored using chi-square or Fisher’s exact tests and Spearman’s correlation. Results: The prevalence of underweight, normal weight, and overweight/obesity was 25.7%, 67.3%, and 6.9%, respectively. Overall, 24.8% of participants presented elevated BP at screening. The BMI category was significantly associated with BP classification (p = 0.003), and BMI correlated positively with systolic BP (ρ = 0.32; p = 0.001). Most children reported only school-based physical education. Conclusions: This school-based screening suggests a high proportion of elevated BP measurements and an unexpectedly high prevalence of underweight children, indicating the coexistence of different nutritional vulnerabilities. Findings should be interpreted cautiously due to the small, single-school sample and single-occasion BP assessment but support the importance of early cardiovascular risk monitoring in vulnerable settings. Full article

Background/Objectives: The high prevalence of obesity and obesity-associated diseases in the United States and worldwide places a tremendous burden on public health. Although lifestyle interventions, such as calorie-restricted diets and increased exercise, are generically recommended to individuals with overweight and obesity, it is well acknowledged that individual responses to the same lifestyle intervention vary significantly, underscoring the importance of individualized or precision nutrition-based approaches in obesity management. Methods: In a recent randomized, parallel-arm pilot study, manuka honey (21 g) was given daily to overweight and obese participants aged 40–75 years for four weeks. The levels of plasma interleukin (IL)-6 at the baseline and after honey treatment were measured. The 14 female participants were stratified into responder (R) and non-responder (NR) groups, based on their circulating IL-6 level changes. Plasma and fecal samples from the R and NR groups were subjected to untargeted metabolomics analysis and 16S rRNA analysis, respectively. Results: Among the female participants with overweight and obesity, 50% had reduced plasma levels of IL-6 after honey intake, and other 50% showed no such responses. Untargeted metabolomics analysis demonstrated that 22 metabolites markedly increased and eight decreased in the R group, relative to the NR group. A decrease in circulating glutamic acid could potentially predict the responsiveness to honey intake. 16S rRNA analysis showed that 23 and 14 genera were uniquely enriched in the R and NR groups, respectively. Enriched Bacteroides and Akkermansia in the R group are capable of metabolizing glutamic acid and thus may contribute to the decreased level of circulating glutamic acid. Conclusions: In this pilot study, participants with overweight and obesity showed different responses to honey intake. Circulating glutamic acid may have the potential to predict the responsiveness of patients to honey and provide guidance for precision nutrition-based dietary intervention. Full article

Obesity is a global health concern affecting all income levels, with body mass index (BMI) traditionally used for diagnosis. However, BMI does not accurately reflect body composition. Normal weight obesity (NWO) describes individuals with a normal BMI but elevated body fat percentage and has been associated with metabolic abnormalities and reduced physical fitness. This cross-sectional study included 384 adults aged 18–40 years with a BMI between 18.5 and 24.9 kg/m². Anthropometric measurements and body composition were assessed using an InBody H20 bioelectrical impedance device, and handgrip strength was measured with a Camry electronic dynamometer. NWO was defined as body fat percentage ≥20% in men and ≥30% in women. The overall prevalence of NWO was 77.3%. Although prevalence appeared higher in men than in women, this difference was not statistically significant after adjustment for multiple comparisons. Participants with NWO showed significantly higher body fat percentage, visceral fat index, hip circumference, and blood pressure compared with normal weight non-obese individuals after Holm–Bonferroni correction. Skeletal muscle mass was lower in the NWO group, although this difference did not remain statistically significant after adjustment. Multivariate logistic regression identified right-hand grip strength as an independent protective factor against NWO. Full article

In our surgical center, we have observed a high occurrence of hiccups and rhinorrhea following bariatric surgery. This retrospective study aimed to assess the frequency of post-prandial hiccups and rhinorrhea following bariatric surgery and explore potential behavioral and clinical associations. The study was performed at Cannizzaro Hospital (Catania, Italy), an institution accredited by SICOB (Italian Society for Bariatric and Metabolic Surgery) as a national referral center. The cohort included bariatric patients who completed a preoperative psychological evaluation and adhered to a one-year post-surgical follow-up between October 2022 and November 2023. Data on eating behaviors, mental status and dietary habits were collected for each patient before surgery, while clinical records, including the recurrence of hiccups and rhinorrhea, were acquired at the following time points: baseline and 1, 3, 6 and 12 months post-surgery. Post-prandial hiccups and/or rhinorrhea were reported by 49.5% of patients at 1 month and persisted in 46.8% after 12 months. No significant associations were found between the symptoms and weight loss, BES score, or psychological traits, except for slight associations with smoking and carbonated beverage intake. In our cohort, the etiology of hiccups and rhinorrhea appears unrelated to behavioral or psychological factors and may instead reflect vagal hyper-responsiveness after gastric fundus resection. Full article

Obesity is a major global health challenge that substantially affects vitamin D metabolism and status. Numerous studies have consistently demonstrated an inverse relationship between body fat and serum 25-hydroxyvitamin D [25(OH)D] concentrations. Emerging evidence suggests that lower serum 25(OH)D in obesity largely reflects altered distribution and metabolism rather than a uniform state of true functional deficiency. Adipose tissue functions both as a storage compartment and as a metabolically active organ capable of modulating vitamin D handling. Mechanisms include the sequestration of vitamin D in fat, volumetric dilution across a larger body mass, and the local expression of enzymes involved in vitamin D metabolism. As a result, obese individuals typically exhibit a blunted increase in serum 25(OH)D in response to supplementation, consistent with altered pharmacokinetics and increased distribution volume. Weight loss, particularly the reduction in visceral fat, is associated with modest increases in circulating 25(OH)D, further supporting a distribution-based mechanism. Although low 25(OH)D levels in obesity have been linked to insulin resistance, inflammation, and metabolic syndrome, randomized controlled trials have not consistently demonstrated that supplementation improves clinically relevant outcomes in this population. Meta-analyses confirm that the increase in serum 25(OH)D after supplementation is smaller in obese individuals, indicating that higher doses are often required to achieve comparable levels to those in normal-weight subjects. Obesity thus represents a major determinant of vitamin D deficiency, highlighting the need for individualized supplementation strategies alongside weight management. Understanding the mechanistic basis for low 25(OH)D in obesity is essential for distinguishing true deficiency from altered distribution, informing clinical decisions, and optimizing interventions to maintain adequate vitamin D status and support metabolic health. Full article

Endoscopic sleeve gastroplasty (ESG) does not produce homogeneous results, with some patients showing little weight loss after the procedure. The aim of the present study was to evaluate the ability of pre-procedural psychometric questionnaires to predict insufficient weight loss after ESG in patients with obesity. Patient candidates for ESG were requested to complete the following psychometric questionnaires: Short Form-36 (SF-36), Symptom Checklist-90 Revised (SCL-90-R), Binge Eating Scale (BES), Yale Food Addiction Questionnaire (Y-FAS), Eating Attitude Test-26 (EAT-26), and Barratt Impulsiveness Scale-11 (BIS-11). The results of the psychometric scores were then compared with the ESG outcome, which was considered a therapeutic failure if the %EWL was less than 30% at 12 months after the follow-up. Thirty-five patients (8 males and 27 females, mean age 49 years, range 21–75 years) were included in this study. At the one-year follow-up, the mean %EWL was 40 ± 43%. Male sex and higher preoperative BMI were identified as risk factors for poor weight loss. A logistic regression analysis adjusted for sex and preoperative BMI showed that low scores on the SF-36 (Subscale Mental Health), high scores on the SCL_90-R, and an elevated BES score were predictors of therapeutic failure. The results of the present study seem to confirm the usefulness of the SF-36, SCL-90R, and BES questionnaires in the selection of patients eligible for ESG. Full article

The American Academy of Pediatrics recently revised its guidelines on pediatric obesity treatment to recommend that primary care providers offer anti-obesity medications to patients based on age and body mass index. Anti-obesity medications like glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are efficacious in lowering body mass index (BMI) and improving metabolic health, including in children. However, although the landscape for medication production and insurance coverage is rapidly evolving, these medications can be difficult to access due to cost, lack of insurance coverage, and supply chain issues. Compounded versions of GLP-1 RAs offer the benefits of providing lower cost and higher availability alternatives to FDA-approved versions. But they include risks associated with less regulated medications. This paper identifies the risks and benefits of compounded GLP-1 RA use in the pediatric population, particularly considering structural inequities in obesity burden and treatment, and offers recommendations for pediatricians to ethically and equitable address compounded GLP-1 RA use with their patients and their families. Full article

Nutritional deficiencies and metabolic alterations are common complications following bariatric surgery, requiring often lifelong monitoring and supplementation. The aim of this retrospective study is to investigate whether a structured follow-up can mitigate micronutrient deficiencies and metabolic changes. This study was conducted at Cannizaro Hospital (Catania, Italy), a national referral center accredited by SICOB (Italian Society for Bariatric and Metabolic Surgery). The cohort included patients who underwent bariatric surgery who completed one year follow-up between October 2022 and May 2024. Medical records such as anthropometric, clinical and laboratory data were collected for each patient at five different timepoints: baseline, 1-, 3-, 6- and 12-months post-surgery. Serum levels of iron, hemoglobin, vitamin D, folate, vitamin B12 and uric acid were analyzed to assess nutritional and metabolic status over time. One-year follow-up adherence of the patient cohort was equal to 97.5%. A significant increase in serum iron, vitamin D and folate levels was observed one year after surgery. Hemoglobin and vitamin B12 levels remained stable over time. Uric acid showed a significant rise at 1 month after surgery, followed by a progressive reduction by 12 months. This study highlights the importance of a structured follow-up program after bariatric surgery, contributing to the prevention of common postoperative complications. Full article