Obesities

Lycium barbarum (L. barbarum), commonly known as goji berry, is a functional food recognised for its diverse phytochemical composition and health benefits, particularly in metabolic health and disease prevention. This review explores its phytochemistry, focusing on polysaccharides, carotenoids, polyphenols, and alkaloids, which contribute to its extensive biological activities. L. barbarum polysaccharides, the primary bioactive components, exhibit antioxidant, immunomodulatory, and glycaemic-regulating properties, making them promising candidates for managing obesity-related metabolic disorders. Carotenoids, particularly zeaxanthin, play a key role in ocular health, while polyphenols and alkaloids enhance antioxidant, antimicrobial, and hepatoprotective effects. The biological properties of L. barbarum span metabolic health, cardiovascular function, and glycaemic control, alongside neuroprotection and cancer prevention. Its prebiotic effects on gut microbiota modulation offer additional benefits in managing obesity and associated complications. Furthermore, its antioxidant and anti-inflammatory activities support its role in alleviating oxidative stress and chronic inflammation, common in obesity and metabolic syndrome. Despite robust preclinical evidence, further studies are needed to validate its safety, efficacy, and long-term potential in human populations. This review highlights L. barbarum’s promising applications as a nutraceutical and therapeutic agent, particularly for metabolic and obesity-related health challenges. Full article

The diagnosis of obesity is conventionally determined by the Body Mass Index (BMI), with a threshold of 30 being extensively accepted. However, the validity of this cutoff point is subject to variation due to ethnic differences, and its accuracy in the Mexican population remains unvalidated. This cross-sectional, observational, and analytical study endeavored to assess the diagnostic performance of BMIs ≥ 30 in comparison to body fat determination using bioimpedance. A total of 715 Mexican adults, aged over 18 years were analyzed. Anthropometric measurements, including weight, height, and BMI, were recorded, and body fat percentage was assessed. The results showed that BMIs ≥ 30 had a sensitivity of 62.4%, a specificity of 93.9%, a positive predictive value (PPV) of 95.5%, and a negative predictive value (NPV) of 54%. In contrast, a BMI cut-off of ≥27 demonstrated superior diagnostic performance, with a sensitivity of 81.3%, specificity of 82.5%, PPV of 90.8%, and NPV of 67.3%. The chi-square test revealed a significant difference in obesity diagnosis between bioimpedance and BMIs ≥ 30 (p < 0.05). These findings suggest that the current BMI cutoff of ≥30 underestimates obesity diagnosis, while a cutoff of ≥27 may provide a more accurate diagnostic threshold, emphasizing the necessity for population-specific adjustments. Full article

(1) Background: Spatial energy expenditure patterns, driven by physical activity, particularly among females, remain underexplored in Ghana. This study, therefore, investigates spatial energy expenditure clustering or dispersion patterns using metabolic equivalents of task (METs) values among Ghanaian females across rural and urban areas. (2) Methods: Using 13,799 data from the 2022 Ghana Demographic and Health Survey, METs values were assigned to self-reported occupation categories as proxies for physical activity. Global and local spatial autocorrelation metrics (Queen contiguity and Moran’s I) were employed to assess spatial clustering or dispersion of METs values across the 16 administrative regions. (3) Results: Rural females reported higher METs (mean = 3.35 ± 1.627) and lower BMI (23.476 ± 3.888) than urban females (METs: mean = 2.42 ± 1.208, BMI: 25.313 ± 4.854). There was a significant but weak global spatial autocorrelation (Moran’s I = 0.003, p-value = 0.001), with stronger clustering observed in rural (Moran’s I = 0.004, p-value = 0.001) than in urban areas (Moran’s I = 0.002, p-value = 0.002). Also, High–High clusters were prevalent in the Northern, Savannah and Northeast regions particularly due to the lingering labour-intensive occupations as compared to Low–Low clusters in the Eastern and Greater Accra regions where jobs are often desk-based and sedentary. (4) Conclusions: Given the revealed geographic heterogeneity (High–High and Low–Low clustering) of female energy expenditure in Ghana, there is a need for regionally tailored health policies targeting physical inactivity and its associated risks. Full article

Background: Obesity adversely affects sleep quality through mechanisms such as obstructive sleep apnea (OSA) and hormonal imbalances that disrupt the circadian rhythm. High-intensity interval training (HIIT) helps reduce fat, inflammation, and stress, which in turn leads to improvements in deep and restful sleep. Method: This study aimed to examine the effects of HIIT on sleep quality in obese patients through a systematic review and meta-analysis of studies published in five databases: PubMed, Scopus, Ovid, The Cochrane Library, and Google Scholar. Randomized controlled trials (RCTs) comparing obese patients undergoing HIIT with control groups and assessing sleep quality via subjective measures such as the Pittsburgh Sleep Quality Index (PSQI) and objective assessments were included. Result: Eight eligible studies were identified, with six included in the meta-analysis, comprising a total of 191 participants. The analysis revealed that HIIT significantly improved overall sleep quality, as evidenced by a reduction in PSQI scores (mean difference, −3.51; 95% CI (−4.78, −2.25); p < 0.001). Significant improvements were also observed in PSQI subscales, including sleep duration (mean difference, −0.42; 95% CI (−0.58, −0.26); p < 0.001), habitual sleep efficiency (mean difference, −0.32; 95% CI (−0.59, −0.05); p = 0.02), and daytime dysfunction (mean difference, −0.66; 95% CI (−1.27, −0.05); p = 0.03). Moreover, HIIT led to a notable reduction in OSA severity, as reflected by lower Apnea–Hypopnea Index (AHI) scores (mean difference, −28.31, 95% CI (−34.39, −22.22); p < 0.001). Conclusion: HIIT significantly improves sleep quality in obese patients and reduces the severity of obstructive sleep apnea. Further long-term studies with improved control of confounding factors are recommended to validate and strengthen these findings. Full article

Reducing abdominal subcutaneous fat is a common concern among women, with evidence suggesting that combining aerobic exercise with external shock waves or radiofrequency may enhance fat reduction. This study aimed to assess the effects of six sessions of external shock wave therapy or radiofrequency combined with an aerobic exercise program on abdominal subcutaneous fat and lipid mobilization, compared to the effects of an aerobic exercise program alone. Thirty-one women (aged 18–60) were randomly assigned to three groups: EG1 (shockwave therapy + aerobic exercise), EG2 (radiofrequency + aerobic exercise), and CG (aerobic exercise only). Body composition measures, mean temperature, adipose tissue thickness, lipid profile, and glycerol and interleukin-6 levels were assessed before and after intervention. A significant decrease in the EG groups compared to the CG was observed in the subcutaneous abdominal thickness (p < 0.001, effect size of η²p = 0.446) and waist–hip ratio (p ≤ 0.001, effect size of η²p = 0.408). No significant changes were verified in the levels of lipolytic activity, lipid profile, and interleukine-6. Six sessions of shockwave or radiofrequency therapy combined with aerobic exercise reduced subcutaneous fat thickness and improved hip–waist ratio more effectively than aerobic exercise alone, without affecting lipid mobilization by changes in lipid profile, lipolytic activity, or interleukin-6 levels. Full article

In aging, chronic diseases such as obesity accelerate metabolic dysfunction through chronic inflammation and insulin resistance. This review compared three different dietary strategies to evaluate their mechanisms and benefits for metabolic health and longevity. A comprehensive database search was conducted, selecting studies in animal models and in humans with or without obesity which have been published since 2004. Fasting-mimicking diets reduce IGF-1, promote autophagy, and improve insulin sensitivity, although long-term adherence remains a challenge. Time-restricted feeding synchronizes food intake with circadian rhythms, benefiting inflammation, glycemic control, and body composition. Protein and amino acid restriction, particularly methionine and branched-chain amino acids, modulates mTOR and reduces oxidative stress but requires adjustments in older adults. According to the available evidence, each intervention offers a non-invasive and adaptive approach to mitigating the effects of aging, provided it is applied in a personalized manner with appropriate follow-up. Full article

Background/Objectives: Obesity is a chronic, progressive, recurrent disease associated with impaired health, affecting an increasing proportion of the population worldwide. Newer-generation incretin-based therapies (IBTs) (liraglutide, semaglutide, and tirzepatide) have shown greater efficacy than older anti-obesity medications. This systematic literature review provides an overview of the evidence on the symptomatic adverse events (AEs) and patient-reported outcomes of IBTs to facilitate clinical decision-making. Methods: A systematic search was conducted using a predefined search strategy to identify controlled trials and real-world evidence (RWE) studies assessing IBTs. Results: Among 4414 publications identified, 81 (>400,000 participants) were included. Liraglutide (n = 49), semaglutide (n = 34), and tirzepatide (n = 7) were used in 48 clinical and 33 RWE studies. Gastrointestinal (GI) AEs were most common: placebo-subtracted incidences were 5–39% for nausea, −7–39% for diarrhea, 2–31% for constipation, 0–26% for vomiting, and 2–20% for abdominal pain, with no clear difference across IBTs. Most AEs were mild or moderate and mainly occurred during dose escalation. Quality of life outcomes were reported in 27 publications and generally showed improvements with IBTs. Conclusions: This study confirms that GI AEs are common with IBTs. Clinicians should keep the AE profile of IBTs in mind and consider where additional preventative measures may be required. Full article

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