Journal Description
Obesities
Obesities
is an international, peer-reviewed, open access journal on all aspects of obesity published bimonthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), Scopus and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 21.6 days after submission; acceptance to publication is undertaken in 3.3 days (median values for papers published in this journal in the first half of 2026).
- Recognition of Reviewers: Reviewers whose reports are timely and of high quality receive an APC discount voucher for a future publication in an MDPI journal. Become a reviewer.
- Journal Cluster of Food, Nutrition, and Health Science: Beverages, Dietetics, Foods, Nutraceuticals, Nutrients and Obesities.
Impact Factor:
1.6 (2025);
5-Year Impact Factor:
1.6 (2025)
Latest Articles
Fluid Distribution Index and Bioelectrical Impedance Analysis in Adolescents and Adults: Reference Values in People Residing in Mexico
Obesities 2026, 6(5), 63; https://doi.org/10.3390/obesities6050063 - 3 Sep 2026
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Background: Bioelectrical impedance vector analysis (BIVA) allows assessment of body composition and fluid distribution without relying on predictive equations. However, recent evidence shows that reference values from three decades ago are outdated and population-specific references are required. No large-scale BIVA references exist for
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Background: Bioelectrical impedance vector analysis (BIVA) allows assessment of body composition and fluid distribution without relying on predictive equations. However, recent evidence shows that reference values from three decades ago are outdated and population-specific references are required. No large-scale BIVA references exist for populations residing in Mexico. Objectives: (1) to establish sex-stratified BIVA tolerance ellipses in a large sample of adolescents and adults (16–60 years) from Guadalajara; (2) to characterize the distribution of the extracellular-to-total body water ratio (ECW/TBW) index and its association with phase angle (PhA); (3) to describe age-specific PhA percentile normative values; and (4) to examine the relationship between body mass index (BMI) category and BIVA parameters. Methods: Cross-sectional observational study of 5271 participants (3455 women, 1816 men; mean age 23.3 ± 6.6 years) assessed with the InBody® 720 multifrequency segmental analyzer in Guadalajara, Mexico (2017–2023). PhA, BIVA tolerance ellipses (50th, 75th, and 95th percentiles), and the extracellular water/total body water ratio (ECW/TBW) were calculated. Sex-specific mean vectors were compared using Hotelling’s T2 test and the Mahalanobis distance (D). Results: PhA was significantly higher in men (6.39 ± 0.57°) than in women (5.37 ± 0.56°; Cohen’s d = 1.81; p < 0.001). Mean BIVA vectors differed markedly by sex (Hotelling’s T2, p < 0.001; D = 2.42). The ECW/TBW ratio was higher in women (0.378 ± 0.006) than in men (0.371 ± 0.006; d = 1.13). A total of 29.8% of women fell within the high-normal band (0.381–0.390) versus 5.0% of men (p < 0.001). PhA correlated strongly and inversely with ECW/TBW in both sexes (women r = −0.85; men r = −0.86; both p < 0.001), and PhA increased across BMI categories from underweight to overweight in both sexes (one-way ANOVA, p < 0.001). The bioimpedance centroids of this cohort residing in Mexico were descriptively displaced relative to previous European and North American references; ethnic origin was not recorded, so this displacement cannot be attributed to ethnicity. Conclusions: The tolerance ellipses and PhA percentile norms presented here are device-specific and constitute a population reference for clinical nutritional assessment, monitoring of fluid distribution in university health programs, and future longitudinal studies in Latin American populations. The marked differences from existing international references highlight the need for population-specific standards to achieve a valid clinical interpretation of bioimpedance parameters in Latin American populations.
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Open AccessArticle
Translation, Cultural Adaptation, and Evaluation of the Psychometric Properties of the Greek Version of the Rapid Weight Loss Questionnaire for Combat Sports Athletes
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Pinelopi S. Stavrinou, Christoforos D. Giannaki, George Aphamis, Ioannis N. Kostikiadis, Elena Philippou, Angelos Vlahoyiannis, Eleni Andreou and Gregory C. Bogdanis
Obesities 2026, 6(5), 62; https://doi.org/10.3390/obesities6050062 - 28 Aug 2026
Abstract
Rapid weight loss (RWL) is commonly practiced among combat sports athletes to reduce body mass before competition. The Rapid Weight Loss Questionnaire (RWLQ) is a self-report instrument designed to assess weight loss behaviors and practices. This study aimed to translate and culturally adapt
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Rapid weight loss (RWL) is commonly practiced among combat sports athletes to reduce body mass before competition. The Rapid Weight Loss Questionnaire (RWLQ) is a self-report instrument designed to assess weight loss behaviors and practices. This study aimed to translate and culturally adapt the RWLQ into Greek (RWLQ-GR), evaluate its psychometric properties, and examine the prevalence, magnitude, and methods of RWL among Greek-speaking combat sports athletes. The translation and cultural adaptation process followed established international guidelines. Measurement properties were examined in terms of test–retest reliability, known-groups and convergent validity. A total of 209 Greek-speaking combat sports athletes were included in the final analysis, of whom 34 completed the questionnaire twice for the test–retest reliability assessment. Overall, 92% of participants reported engaging in weight loss before competition, with a median body mass reduction of 4.5%. The RWLQ-GR demonstrated high test–retest reliability for numerical items and total score. Categorical items showed fair to excellent reliability. No systematic differences were observed between repeated administrations of the questionnaire. The questionnaire differentiated athletes according to their usual weight loss, providing supportive evidence for known-group validity. Evidence of convergent validity was limited: the RWLQ-GR total score was not associated with the EAT-26 total score and correlated weakly with the Bulimia and Food Preoccupation subscale only. Overall, these findings support the use of the RWLQ-GR for the assessment and surveillance of self-reported RWL behaviors in Greek-speaking combat sports athletes.
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Open AccessArticle
Relative BMI (rBMI) Cut-Points for Adolescent Adiposity Severity: Derivation, Stability, and Internal Validation
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Amr Mohamed, Begüm Kara Gülay, Patricia A. Cowan and Pedro A. Velasquez-Mieyer
Obesities 2026, 6(5), 61; https://doi.org/10.3390/obesities6050061 - 25 Aug 2026
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Objectives: To derive sex-specific Relative Body Mass Index (rBMI) cut-offs for classifying adolescents into four adiposity categories defined by dual-energy X-ray absorptiometry (DXA)-based body fat percentage (BF%), quantify their stability, and evaluate their classification performance against current BMI%-based classification and previously published ROC-derived
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Objectives: To derive sex-specific Relative Body Mass Index (rBMI) cut-offs for classifying adolescents into four adiposity categories defined by dual-energy X-ray absorptiometry (DXA)-based body fat percentage (BF%), quantify their stability, and evaluate their classification performance against current BMI%-based classification and previously published ROC-derived rBMI cut-offs. Materials and Methods: Data from 567 observations in adolescents aged 11–19 years were analyzed. Adiposity categories (normal, mildly elevated, moderately elevated, severely elevated) were defined by sex-specific BF% thresholds. Classification and Regression Tree models with inverse class-frequency weighting were fitted in two formulations: sex-stratified, and a pooled-threshold model with shared lower boundaries and sex-specific upper boundaries. Threshold stability was assessed by bootstrap resampling. Performance was estimated by repeated nested cross-validation, with the full derivation pipeline repeated within each training fold; the previously published ROC-derived thresholds were re-derived within each fold so that both approaches carried the same correction for optimism. Results: Sex-stratified thresholds were 103, 118, and 162 in males and 100, 118, and 176 in females; three of six agreed with the previously published ROC-derived values to within 0.5 units and a fourth to within 3.2 units. Five of the six published values fell within the corresponding bootstrap intervals, the exception being the female moderately/severely elevated boundary (160.0; 95% CI: 161.4–218.7). The male boundary separating normal from mildly elevated adiposity was identified in 76.0% of bootstrap resamples; estimating the lower boundaries from the pooled sample raised this to 99.9% and improved ordinal agreement among males (quadratic-weighted kappa 0.812 vs. 0.759). Out-of-fold accuracy was 0.697, 0.694, and 0.694 for the sex-stratified, pooled-threshold, and ROC-derived approaches, respectively, with all paired differences including zero in the overall sample. All three exceeded BMI% classification (accuracy 0.608), which identified only 15.5% of adolescents with mildly elevated adiposity and produced more than twice the proportion of errors spanning two or more categories (6.0% vs. 1.8–2.1%). Conclusions: rBMI cut-offs aligned more closely with DXA-defined adiposity than BMI% classification, particularly in the intermediate categories. Tree-derived and ROC-derived thresholds converged and performed equivalently, indicating that threshold location does not depend on the derivation procedure. A pooled-threshold formulation provided a simpler and more stable rule. These are derivation-stage estimates requiring external validation before clinical adoption.
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Open AccessArticle
Two Faces of Sarcopenia: Distinct Metabolic and Cardiometabolic Signatures Across Obese and Non-Obese Phenotypes in a Multi-District Urban Population in Jakarta—A Cross Sectional Study
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Alexander Halim Santoso, Yohanes Firmansyah, Triyana Sari, Alfianto Martin, Andria Priyana, Bryan Anna Wijaya, Diana Dinali, Muhammad Fikri Dzakwan, Ajeng Tias Endarti, Ernawati, Sari Mariyati Dewi Nataprawira and Hendsun Hendsun
Obesities 2026, 6(5), 60; https://doi.org/10.3390/obesities6050060 - 24 Aug 2026
Abstract
Introduction: Sarcopenia and obesity are increasingly recognized as overlapping conditions that contribute to adverse health outcomes, particularly in rapidly urbanizing populations. The coexistence of both conditions, termed sarcopenic obesity, represents a complex phenotype with potentially greater metabolic burden, yet its differentiation from non-obese
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Introduction: Sarcopenia and obesity are increasingly recognized as overlapping conditions that contribute to adverse health outcomes, particularly in rapidly urbanizing populations. The coexistence of both conditions, termed sarcopenic obesity, represents a complex phenotype with potentially greater metabolic burden, yet its differentiation from non-obese sarcopenia remains insufficiently explored. Aim: This study aimed to compare metabolic and cardiometabolic profiles between sarcopenic obesity and non-obese sarcopenia in an urban population. Methods: A cross-sectional study was conducted using secondary data from the PRIMBON 2025 database in Jakarta, Indonesia. Participants were adults aged ≥18 years diagnosed with sarcopenia based on the 2025 Asian Working Group for Sarcopenia (AWGS) criteria. Sarcopenic obesity was defined according to the 2025 AOASO–IAGG consensus using BMI ≥ 25 kg/m2 and visceral fat level > 10. A total of approximately 604 participants were included from five administrative regions of Jakarta. Data were analyzed using Mann–Whitney U test and Chi-square test, with results presented as median (min–max), mean rank, and odds risk (OR). A dot-and-whisker plot was used to visualize effect sizes. Results: Sarcopenic obesity was associated with older age and a higher proportion of males (p < 0.01). Significant differences were observed in systolic and diastolic blood pressure, fasting blood glucose, triglycerides, and HDL (all p < 0.01), indicating a more adverse cardiometabolic profile. No significant differences were found for hemoglobin, total cholesterol, LDL, uric acid, and handgrip strength. Conclusions: Sarcopenic obesity represents a more severe metabolic phenotype compared to non-obese sarcopenia.
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(This article belongs to the Topic Nutrition, Obesity and Metabolic Diseases)
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Open AccessArticle
Temporal Patterns and Cross-Sectional Correlates of BMI-Defined Weight Status Among Mexican Adults Aged 50 Years and Older
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Alberto Retana-Guzman, Israel Rico-Alba, Jessie Nallely Zurita-Cruz, Horacio Marquez-González, Elena García and Rodrigo Peña
Obesities 2026, 6(4), 59; https://doi.org/10.3390/obesities6040059 - 11 Aug 2026
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Background: Fluctuations in body mass index (BMI) have been associated with frailty, functional decline, and increased morbidity and mortality. However, evidence on the longitudinal evolution of weight status in aging populations remains limited. This study aimed to characterize population-level patterns and individual longitudinal
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Background: Fluctuations in body mass index (BMI) have been associated with frailty, functional decline, and increased morbidity and mortality. However, evidence on the longitudinal evolution of weight status in aging populations remains limited. This study aimed to characterize population-level patterns and individual longitudinal fluctuations in BMI-defined weight status among Mexican adults aged 50 years and older between 2001 and 2021 and to examine factors associated with BMI categories across survey waves. Methods: This observational study was based on a secondary analysis of data from the Mexican Health and Aging Study (ENASEM). Data from the 2001, 2003, 2012, 2015, 2018, and 2021 survey waves were analyzed. Weight status was classified according to BMI as underweight, normal weight, overweight, or obesity. Differences in weight status were assessed using χ2 tests adjusted for the complex survey design. Results: Most participants remained in the same BMI category during follow-up; however, relevant transitions between categories were observed, particularly between 2001–2003 and 2018–2021. The longitudinal analysis showed that 32% to 38% of individuals changed BMI category between periods. Obesity showed high persistence, whereas overweight showed greater variability. Wave-specific cross-sectional analyses showed that older age was consistently associated with lower BMI-category position, whereas several socioeconomic and clinical characteristics also exhibited cross-sectional associations with BMI category across survey waves. Conclusions: Although the population-level BMI distribution showed relative stability, relevant individual-level fluctuations were observed. Age and several sociodemographic characteristics were associated with differences in weight status patterns.
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(This article belongs to the Special Issue Obesity in the 21st Century: Public Health Perspectives and Population Solutions)
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Open AccessArticle
Preoperative Factors Including Endoscopic Findings in Predicting Gastroesophageal Reflux Disease (GERD) After Sleeve Gastrectomy: An Observational Cohort Study
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Justyna Rymarowicz, Mateusz Michalczak, Izabela Powalacz, Jakub Michalczak, Anna Dąbrowska, Józefina Jamsran and Piotr Major
Obesities 2026, 6(4), 58; https://doi.org/10.3390/obesities6040058 - 9 Aug 2026
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Background: Gastroesophageal reflux disease remains a common postoperative issue after sleeve gastrectomy. This study examined whether preoperative symptoms, clinical factors, and endoscopic findings predict reflux symptoms one year after surgery. Methods: We performed an observational cohort study including 207 patients who underwent sleeve
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Background: Gastroesophageal reflux disease remains a common postoperative issue after sleeve gastrectomy. This study examined whether preoperative symptoms, clinical factors, and endoscopic findings predict reflux symptoms one year after surgery. Methods: We performed an observational cohort study including 207 patients who underwent sleeve gastrectomy (SG). Preoperative variables included age, sex, BMI, comorbidities, preexisting GERD symptoms, and esophagogastroduodenoscopy (EGD) results. GERD symptoms were evaluated at 1 year. Multivariable logistic regression identified factors associated with GERD after surgery, GERD resolution, and de novo GERD. Results: One year after SG, the prevalence of GERD increased from 45% to 60% (p = 0.003). Preexisting GERD symptoms (OR 2.54 (95% CI 1.39–4.63, p = 0.002) and lower preoperative BMI (OR 0.93; 95% CI 0.88–0.99; p = 0.027) were independently linked to GERD after surgery. Among patients with preoperative GERD, higher preoperative BMI was associated with symptom resolution (OR 1.11; 95% CI 1.03–1.21; p = 0.011). Neither Hill classification nor mild-to-moderate (Los Angeles grade A/B) esophagitis on EGD predicted GERD outcomes. Conclusions: Preexisting GERD symptoms and BMI were the most reliable predictors of GERD after surgery. Preoperative Hill classification and esophagitis showed no significant association in this cohort.
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Open AccessArticle
Bovine Milk Whey Intake in Offspring Rats Shows Restorative Metabolic Effects Against Negative Fetal Programming Induced by Maternal Obesity
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Brenda Berenice Carranza-Castillo, Sergio Roberto Zamudio-Hernández and Lucia Quevedo-Corona
Obesities 2026, 6(4), 57; https://doi.org/10.3390/obesities6040057 - 6 Aug 2026
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Maternal obesity has been associated with offspring fetal programming, increasing the risk of developing chronic diseases in adulthood, including type 2 diabetes, hypertension, and behavioral disorders such as anxiety and depression. Milk whey (MW) peptides, administered as a supplement, reduce food intake and
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Maternal obesity has been associated with offspring fetal programming, increasing the risk of developing chronic diseases in adulthood, including type 2 diabetes, hypertension, and behavioral disorders such as anxiety and depression. Milk whey (MW) peptides, administered as a supplement, reduce food intake and body weight in overweight rodents. The aim of this work was to study the possible metabolic and behavioral restorative effects of a bovine MW supplement against the negative fetal programming of juvenile offspring. Dam Wistar rats were fed during gestation and lactation with a standard (SD) or a hypercaloric diet (HD); after weaning, the male offspring were fed SD or SD and MW. HD dams showed increases in blood cholesterol, body weight, and calorie intake, while administering MW in offspring from HD mothers reduced these alterations. Serum corticosterone, LDL cholesterol, fasting blood glucose, and glucose intolerance were significantly higher in offspring from HD dams; however, MW did not affect these changes. Offspring from HD dams showed signs of anxiety that were not reversed by MW, as well as a reduction in hippocampal BDNF that was partially restored with MW. Maternal HD consumption during pregnancy and lactation elicited negative developmental programming of adult offspring metabolism, which was partially restored by bovine MW supplementation.
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(This article belongs to the Topic Nutrition, Obesity and Metabolic Diseases)
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Open AccessReview
MicroRNAs and Bariatric/Metabolic Surgery: Biomarkers, Mediators of Metabolic Remission, or Both?
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Antonina Gerganova-Sirakova, Konstantin Grozdev, Antoaneta Gateva, Radka Kaneva, Iveta Nedeva, Yavor Assyov, Vera Karamfilova, Tsvetan Gatev, Darina Kachakova-Yordanova, Veronika Petkova, Radosveta Bozhilova, Silva Kyurkchiyan, Kristina Sirakova and Zdravko Kamenov
Obesities 2026, 6(4), 56; https://doi.org/10.3390/obesities6040056 - 30 Jul 2026
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Purpose of Review: Obesity is a growing global health challenge, with severe obesity projected to affect up to 25% of individuals with obesity by 2030. Bariatric surgery remains the most effective treatment, yet the molecular mechanisms underlying its metabolic benefits are not fully
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Purpose of Review: Obesity is a growing global health challenge, with severe obesity projected to affect up to 25% of individuals with obesity by 2030. Bariatric surgery remains the most effective treatment, yet the molecular mechanisms underlying its metabolic benefits are not fully understood. This review summarizes current evidence on the role of microRNAs in bariatric/metabolic surgery and evaluates their potential as biomarkers and therapeutic targets. Recent Findings: Bariatric surgery induces significant alterations in circulating and tissue-specific miRNA profiles, particularly those involved in glucose metabolism, inflammation, and adipose tissue remodeling. Among the most frequently reported candidates, miR-122, miR-221, miR-27a, miR-126, miR-144, miR-222, miR-223, miR-375, miR-92a, and miR-155 have been associated with weight loss, improved insulin sensitivity, and diabetes remission. Emerging data suggest that these miRNAs may act not only as biomarkers of metabolic recovery but also as regulators of insulin signaling, inflammatory pathways, and adipocyte function. Summary: Current evidence supports a role for miRNAs in the metabolic adaptations observed after bariatric surgery. Although further validation is required, miRNAs show promise as minimally invasive biomarkers for predicting and monitoring treatment response and may provide insight into the molecular mechanisms underlying obesity remission and improvement of obesity-related comorbidities.
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Open AccessArticle
Effect of Supplementing Physical Rehabilitation with Electrostimulation in People with Obesity: A Randomized Controlled Trial
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Lena Seite, Mélodie Garot, Madeline Gate, Cristian Preda, Marion Buyse and Marie-André Salaun
Obesities 2026, 6(4), 55; https://doi.org/10.3390/obesities6040055 - 17 Jul 2026
Abstract
Background: Regular physical activity is recommended for obesity management, but adherence remains difficult for many patients. Neuromuscular electrical stimulation (EMS) has been proposed as an adjunctive intervention. Methods: In this prospective, single-center, randomized controlled trial, adults with severe or morbid obesity (BMI ≥
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Background: Regular physical activity is recommended for obesity management, but adherence remains difficult for many patients. Neuromuscular electrical stimulation (EMS) has been proposed as an adjunctive intervention. Methods: In this prospective, single-center, randomized controlled trial, adults with severe or morbid obesity (BMI ≥ 35 kg/m2) enrolled in a three-week inpatient rehabilitation program were randomized 1:1 to rehabilitation program alone (control group) or rehabilitation supplemented with EMS (5 sessions/week, 20 min/session, 75 Hz). Outcomes assessed at admission and discharge included body composition, lipid and glucose metabolism, continuous glucose monitoring, physical capacity, quality of life, adherence, and safety. Results: Both groups showed significant improvements in BMI, waist circumference, body composition, lipid and carbohydrate profiles, and physical performance assessed by the 6 min walk test, without significant between-group differences. BMI decreased by −0.9 kg/m2 in controls and −1.2 kg/m2 in the EMS group (both p < 0.001). Waist circumference also decreased significantly in both groups. EMS showed a potential effect on continuous glucose monitoring parameters, but this was no longer significant after adjustment for diabetes status. Conclusions: Adding EMS to inpatient rehabilitation did not provide additional benefits for weight loss or body composition.)
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(This article belongs to the Special Issue Exercise and Obesity Beyond Caloric Expenditure: Insights from Clinical and Tactical Populations)
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Open AccessArticle
From Rejection to Reimbursement: Innovative Strategies for Access to Anti-Obesity Pharmacotherapy in Mexico
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Alberto Retana-Guzman, Eunice Carpio-Macedo, Juan Carlos Garnica-Cuellar, Horacio Marquez-González and Jessie Nallely Zurita-Cruz
Obesities 2026, 6(4), 54; https://doi.org/10.3390/obesities6040054 - 17 Jul 2026
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Background: Access to anti-obesity pharmacotherapy within publicly funded healthcare systems remains limited because of concerns regarding affordability, budget impact, and appropriate patient selection. This study describes the methodological and strategic process that enabled the incorporation and public reimbursement of anti-obesity pharmacotherapy for obesity
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Background: Access to anti-obesity pharmacotherapy within publicly funded healthcare systems remains limited because of concerns regarding affordability, budget impact, and appropriate patient selection. This study describes the methodological and strategic process that enabled the incorporation and public reimbursement of anti-obesity pharmacotherapy for obesity management within the Mexican public healthcare system. Methods: A descriptive health policy and market-access analysis was conducted. The reimbursement strategy included five sequential phases: identification of reimbursement barriers, definition of a clinically prioritized target population through expert consensus, generation of local epidemiological evidence, development of pharmacoeconomic and budget impact analyses, and implementation of managed-access and risk-sharing mechanisms. Results: Initial reimbursement attempts were unsuccessful because of concerns regarding the large size of the potentially eligible population and projected budget impact. Sequential application of epidemiological, clinical, and healthcare utilization criteria reduced the potential candidate population from 32,392,801 adults with obesity to 20,412 eligible patients receiving care within public healthcare institutions. Pharmacoeconomic analyses demonstrated favorable cost-effectiveness, while budget impact analyses estimated an average annual investment of MXN $286 million, representing less than 1% of the national pharmaceutical budget over five years. These findings supported the development and regulatory approval of a managed-access strategy that subsequently enabled the incorporation of anti-obesity pharmacotherapy into the National Compendium of Health Supplies in December 2023. Conclusions: Combining local epidemiological evidence, population prioritization, pharmacoeconomic evaluation, and innovative reimbursement mechanisms enabled public access to anti-obesity pharmacotherapy in Mexico. This framework may serve as a model for improving access to obesity therapies in middle-income countries.
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(This article belongs to the Special Issue Obesity in the 21st Century: Public Health Perspectives and Population Solutions)
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Open AccessArticle
Translation and Initial Psychometric Evaluation of a Korean Version of the Modified Weight-Bias Internalization Scale (K-WBIS) in Korean Adult Women
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Si Woo Chae, Katrina T. Obleada and Janet D. Latner
Obesities 2026, 6(4), 53; https://doi.org/10.3390/obesities6040053 - 16 Jul 2026
Abstract
Research has examined the negative consequences of internalized weight bias on mental health (e.g., disordered eating, depression, anxiety). In South Korea’s patriarchal society, appearance rather than ability or talent is considered the principal determinant of a woman’s success, as evidenced by high rates
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Research has examined the negative consequences of internalized weight bias on mental health (e.g., disordered eating, depression, anxiety). In South Korea’s patriarchal society, appearance rather than ability or talent is considered the principal determinant of a woman’s success, as evidenced by high rates of cosmetic surgery and anti-fat bias. Given strict appearance norms and pervasive weight stigma, we developed a Korean version of the Modified Weight Bias Internalization Scale (K-WBIS), examined its psychometric properties, and explored its associations with other established measures. Confirmatory factor analysis was used to assess the factor structure. An item was removed, and a revised 10-item one-factor model was estimated. The final model demonstrated an acceptable incremental model fit indices (CFI = 0.934, TLI = 0.909, SRMR = 0.047), although RMSEA remained elevated (RMSEA = 0.163). The 10-item K-WBIS demonstrated promising psychometric properties in a sample of South Korean adult women. Findings provide preliminary support for the K-WBIS and warrant further evaluation in larger and more diverse Korean-speaking populations.
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Open AccessSystematic Review
Effects of Aquatic Exercise Training on Cardiovascular Functions and Cardiometabolic Risk Factors in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Iqbal Ali Shah, Farhan Yousaf, Shahid Ishaq, Shin-Da Lee and Bor-Tsang Wu
Obesities 2026, 6(4), 52; https://doi.org/10.3390/obesities6040052 - 14 Jul 2026
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Excess adiposity increases cardiovascular and cardiometabolic risks, while aquatic exercise may reduce mechanical barriers to participation. This systematic review and meta-analysis examined aquatic exercise training in individuals with overweight or obesity. PubMed, Web of Science, and the Cochrane Library were searched through to
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Excess adiposity increases cardiovascular and cardiometabolic risks, while aquatic exercise may reduce mechanical barriers to participation. This systematic review and meta-analysis examined aquatic exercise training in individuals with overweight or obesity. PubMed, Web of Science, and the Cochrane Library were searched through to June 2026. Eight randomized controlled trials involving 295 participants were included. Random-effects meta-analyses showed increased VO2 max (MD 3.70 mL·kg−1·min−1, 95% CI 2.49–4.90; p < 0.001) and lower resting heart rate (MD −1.47 beats/min, 95% CI −2.73 to −0.21), systolic blood pressure (MD −4.50 mmHg, 95% CI −7.05 to −1.94), diastolic blood pressure (MD −2.17 mmHg, 95% CI −4.11 to −0.22), triglycerides (MD −15.75 mg/dL, 95% CI −23.12 to −8.39), and fasting glucose (MD −7.82 mg/dL, 95% CI −12.48 to −3.16). No significant pooled effects were observed for total cholesterol, HDL cholesterol, LDL cholesterol, BMI, or body fat percentage. Evidence certainty ranged from low to very low. Aquatic exercise may improve selected cardiovascular and metabolic outcomes, although small samples and heterogeneity limit confidence. Future research must focus on high-quality RCTs to further confirm these findings. PROSPERO: CRD420261340445.
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Open AccessArticle
Real-World Self-Reported Weight Loss During the Use of a Lifestyle Therapy Prescription Digital Therapeutic in Adults with Obesity and Self-Reported Cardiovascular Risk Factors or Cardiovascular Disease
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Kathleen Wiencke, Romina Zimmermann, Annika Gentz, Sara Clever, Saemundur J. Oddsson, Till Hasenberg, David O. Arnar and Andrew Grannell
Obesities 2026, 6(4), 51; https://doi.org/10.3390/obesities6040051 - 11 Jul 2026
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Obesity is a risk factor in cardiovascular disease (CVD), and scalable treatment approaches are needed in routine care. The aim of this retrospective observational study was to investigate self-reported weight change during the use of a prescription digital therapy for multimodal lifestyle therapy
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Obesity is a risk factor in cardiovascular disease (CVD), and scalable treatment approaches are needed in routine care. The aim of this retrospective observational study was to investigate self-reported weight change during the use of a prescription digital therapy for multimodal lifestyle therapy for obesity. Adults with obesity and self-reported CVD risk factors (n = 4314) or self-reported established CVD (n = 1418) prescribed zanadio for up to 12 months were included. The primary outcome was percentage change in self-reported body weight over time. Clinically meaningful weight loss (≥5%) was observed in patients on continued prescriptions, with greater weight loss observed in patients with prolonged program exposure. The results were directionally consistent across analyses that used a randomly missing approach and a sensitivity analysis with the last observation forward, although estimates varied in magnitude. Interpretation of this data in a real-world setting is limited by self-reported weight and comorbidity data, attrition which is typical for weight loss programs in the reality of care, and uncertainty about the mechanism of missing data. These results suggest that zanadio may support clinically meaningful self-reported weight loss in patients continuing treatment, but further studies linking clinical data and with longer follow-up are needed.
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Open AccessArticle
Spousal Obesity Concordance in Male-Headed Cohabiting Couples in Peru: A Cross-Sectional DHS Analysis
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Holly E. Delgado-Toro, Jhonatan Cusma-Regalado, Jhosmer Ballena-Caicedo, Kevin Cusma-Regalado, Fiorella E. Zuzunaga-Montoya and Víctor Juan Vera-Ponce
Obesities 2026, 6(4), 50; https://doi.org/10.3390/obesities6040050 - 9 Jul 2026
Abstract
Obesity is a major public health problem in Peru. Cohabiting couples may show obesity clustering because of partner selection, shared household routines, and broader structural exposures. This study aimed to describe spousal similarity in body mass index (BMI) and obesity status among DHS-eligible
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Obesity is a major public health problem in Peru. Cohabiting couples may show obesity clustering because of partner selection, shared household routines, and broader structural exposures. This study aimed to describe spousal similarity in body mass index (BMI) and obesity status among DHS-eligible male-headed cohabiting couples in Peru and to examine variation across sociodemographic subgroups. We conducted a cross-sectional analysis of DHS 2019 and 2021–2024, excluding 2020. The study included heterosexual cohabiting couples in which the man was the household head aged ≥ 18 years and the woman was the spouse/partner aged 15–49 years, with anthropometric measurements available for both. BMI was calculated from measured weight and height; obesity was defined as BMI ≥ 30 kg/m2. We accounted for the complex survey design and used Pearson correlations, weighted kappa statistics, and Poisson regression with robust variance to estimate crude and exploratory adjusted prevalence ratios (PRs) for obesity clustering. The final analytic sample included 27,604 couples. Obesity prevalence was 25.8% in husbands and 33.3% in wives. Overall, 52.1% of couples had neither spouse with obesity, 14.5% had only the husband with obesity, 22.0% had only the wife with obesity, and 11.3% had obesity in both spouses. BMI correlation between spouses was r = 0.19 (95% CI: 0.18–0.21), the weighted kappa for BMI categories was 0.17, and the crude PR for wife obesity given husband obesity was 1.47 (95% CI: 1.39–1.56). In exploratory adjusted models, the PR for wife obesity given husband obesity was 1.34 (95% CI: 1.26–1.41), and the reverse PR for husband obesity given wife obesity was 1.39 (95% CI: 1.31–1.49). Observed concordance was somewhat stronger in urban, coastal, and wealthier subgroups but remained modest overall. Among DHS-eligible heterosexual cohabiting couples in Peru, restricted to male household heads and female spouses/partners aged 15–49 years, obesity showed positive but modest spousal concordance. These findings support cautious incorporation of couple-level perspectives into obesity surveillance and future research, but they do not establish causal mechanisms or demonstrate the effectiveness of couple-based screening or interventions.
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(This article belongs to the Topic Dietary Habits in Liver Health and Disease: Preclinical and Clinical Studies)
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Open AccessArticle
Associations Between the Maternal Blood Microbiome During Pregnancy and Early Childhood Growth Trajectories: A Pilot Study
by
Qi Zhao, Chi-Yang Chiu, Luhang Han, Anna Joy G. Rogers, Jiawang Liu, Kaja Z. LeWinn and Nicole R. Bush
Obesities 2026, 6(4), 49; https://doi.org/10.3390/obesities6040049 - 8 Jul 2026
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Objective: Maternal blood microbiome signatures during pregnancy have been linked to adverse birth outcomes. We conducted a pilot study to examine whether they are also associated with early childhood growth in offspring and to explore maternal metabolites as potential mediators of these relationships.
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Objective: Maternal blood microbiome signatures during pregnancy have been linked to adverse birth outcomes. We conducted a pilot study to examine whether they are also associated with early childhood growth in offspring and to explore maternal metabolites as potential mediators of these relationships. Methods: This study included 50 mother-child dyads from a prospective pregnancy cohort. Children were selected based on distinct body mass index (BMI) growth trajectories from birth to 4 years, including 25 children in a rising-high-BMI trajectory and 25 in a low-BMI trajectory. Maternal plasma collected during the second trimester underwent 16S rRNA gene sequencing for microbial profiling and an untargeted metabolomics analysis. Microbial diversity indices were compared between groups. Multivariable logistic regression models assessed associations between microbial taxa and BMI trajectories with adjustment for covariates. Mediation analyses evaluated whether maternal metabolites mediated observed associations. Results: Higher maternal blood microbial α-diversity was observed among mothers of children in the rising-high-BMI trajectory. Greater abundance of Gammaproteobacteria/Proteobacteria (class/phylum) was associated with lower odds of membership in the rising-high-BMI trajectory, whereas Bacteroidia/Bacteroidota and Actinobacteria/Actinobacteriota were associated with a greater risk. Mediation analyses identified several maternal metabolites that potentially linked prenatal microbial taxa to child growth outcomes. Key mediators included metabolites involved in benzoate metabolism (e.g., 4-vinylphenol sulfate for taxa Gammaproteobacteria/Proteobacteria), lipid metabolism (e.g., 1-linoleoyl-GPG (18:2) for Bacteroidia/Bacteroidota), glutathione metabolism (cysteinylglycine disulfide for Bacteroidia/Bacteroidota), branched-chain amino acid metabolism (3-hydroxy-2-ethylpropionate for Bacteroidia/Bacteroidota), histidine metabolism (imidazole propionate for Actinobacteria/Actinobacteriota), and TCA cycle (glutaconate for Actinobacteria/Actinobacteriota). These pathways are implicated in oxidative stress, adipocyte differentiation, insulin signaling, and energy metabolism, processes that are highly relevant to obesity development. Conclusion: Findings suggest that prenatal blood microbial signatures may influence early childhood growth through metabolic pathways related to obesity. These pilot study findings support further investigation into the role of prenatal blood microbial signatures in child development and health outcome prediction in larger studies.
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Open AccessArticle
Influence of Latinx Fathers’ Behaviors, Cognitions, Affect, and Family Congruence on Youth Energy Balance-Related Health Outcomes
by
Matthew R. Rodriguez, Ghaffar Ali Hurtado Choque, Kevin Roy and Marla Reicks
Obesities 2026, 6(4), 48; https://doi.org/10.3390/obesities6040048 - 8 Jul 2026
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Obesity is a critical public health issue in the United States, which disproportionately affects Latinx youth compared to youth in other racial/ethnic groups. While research suggests fathers can influence their children’s dietary intake and physical activity behaviors, few studies have included fathers in
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Obesity is a critical public health issue in the United States, which disproportionately affects Latinx youth compared to youth in other racial/ethnic groups. While research suggests fathers can influence their children’s dietary intake and physical activity behaviors, few studies have included fathers in pediatric obesity studies and examined what mechanisms shape youth health outcomes. A greater understanding about fathers’ role modeling and expectations for their youth can provide critical evidence in addressing Latinx youth health outcomes. This research examined the extent to which fathers’ role modeling, expectations, family congruence, and warmth relate to youth energy balance-related behaviors. This study used cross-sectional data collected at baseline before Latinx fathers and children entered an obesity prevention program (n = 193). Latent moderation structural analyses tested the theorized pathways based on Palkovitz’s conceptual framework of father involvement, including youth age and sex as covariates. Fathers’ physical activity role modeling significantly predicted youth moderate-to-vigorous physical activity, p = 0.002. Fathers’ warmth significantly moderated vegetable role modeling, = 0.263, p = 0.019. By testing Palkovitz’s conceptual framework of father involvement, this study increases the understanding about the theorized pathways between fathers’ role modeling/expectations and youth health outcomes.
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Open AccessArticle
The Influence of Emotional Dysregulation on Bariatric Surgery Outcome: A 2-Year Observational Study
by
Margherita Barbuti, Giulia Carignani, Francesco Weiss, Andrea Bordacchini, Claudia Carmassi, Alba Calderone, Ferruccio Santini and Giulio Perugi
Obesities 2026, 6(4), 47; https://doi.org/10.3390/obesities6040047 - 2 Jul 2026
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Background: Bariatric surgery is the most effective long-term treatment for severe obesity; however, a subset of patients fails to achieve optimal weight loss. This study investigated the role of psychiatric disorders and transdiagnostic psychopathological traits in predicting weight loss outcomes two years after
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Background: Bariatric surgery is the most effective long-term treatment for severe obesity; however, a subset of patients fails to achieve optimal weight loss. This study investigated the role of psychiatric disorders and transdiagnostic psychopathological traits in predicting weight loss outcomes two years after surgery. Methods: This prospective naturalistic study included 125 consecutive bariatric surgery candidates undergoing routine preoperative psychiatric assessment. Psychiatric comorbidities, emotional dysregulation and ADHD-related dimensions were assessed using structured clinical interviews and self-report questionnaires. Weight outcomes were evaluated at 24 months after bariatric surgery, with post-surgical inadequate weight loss defined as percentage of excess weight loss (%EWL) < 50%. Results: Of the 125 patients initially assessed, 89 underwent bariatric surgery and 48 completed the follow-up. At 24 months, 10 patients (20.8%) showed inadequate weight loss. Poorer weight outcomes were associated with older age, sleeve gastrectomy, and lifetime mood disorders, whereas no significant associations emerged with anxiety disorders or binge eating disorder. Patients with inadequate weight loss showed higher levels of emotional dysregulation, while no differences emerged for other ADHD-related dimensions. Emotional dysregulation remained significantly associated with poorer weight outcomes in multivariate analysis. Conclusions: Emotional dysregulation may represent a transdiagnostic factor influencing bariatric surgery outcomes, supporting the importance of integrating emotional and cognitive dimensions into preoperative assessment and postoperative care.
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Open AccessArticle
Determinants of Clinically Significant Weight Loss Among People with Obesity: The Roles of Healthcare Engagement, Motivation, and Comorbidities
by
Assim A. Alfadda, Arthur C. Isnani, Mahmoud Shams Eldin, Salini Scaria Joy, Hadeel M. Awwad, Othman M. Othman, Heba Elkhateb and Kenneth Domero
Obesities 2026, 6(4), 46; https://doi.org/10.3390/obesities6040046 - 29 Jun 2026
Abstract
Background: A 5–10% weight loss has shown significant clinical improvements in the overall well-being of people with obesity (PwO). This study investigated the characteristics of PwO, their interaction with healthcare providers (HCP), associated comorbid conditions, and how these factors influence greater weight loss.
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Background: A 5–10% weight loss has shown significant clinical improvements in the overall well-being of people with obesity (PwO). This study investigated the characteristics of PwO, their interaction with healthcare providers (HCP), associated comorbid conditions, and how these factors influence greater weight loss. Methods: A cross-sectional analysis of PwO aged ≥ 18 years using data from the Saudi Arabia Awareness, Care and Treatment in Obesity Management (ACTION-IO) study. We evaluated the relationship between PwO who achieved 5 to <10% weight loss (LWL) and those who achieved ≥10% weight loss (HWL) during the preceding 3 years. Owing to the cross-sectional design, associations rather than causal relationships were evaluated between participant characteristics and clinically significant weight loss. Results: A total of 842 PwO were surveyed, 133 (15.8%) had HWL, and 709 (84.2%) had a weight loss of <10% within 3 years (LWL). HWL was observed in individuals with cardiovascular disease and depression/anxiety, as well as those who were motivated and committed to weight-loss interventions. PwO who had LWL had fewer interactions with their HCP and had a lack of support from friends and family. After adjustment for demographic factors, exercise, and weight-loss medication use, having discussed weight management with a healthcare provider within the previous 6 months (OR = 2.525, 95% CI = 1.692–3.768, p < 0.001), commitment to weight-loss action (OR = 1.572, 95% CI = 1.071–2.309, p = 0.021), cardiovascular disease (OR = 2.496, 95% CI = 1.175–5.300, p = 0.020), and depression/anxiety (OR = 2.734, 95% CI = 1.605–4.655, p < 0.001) were independently associated with achieving ≥10% weight loss. Conclusion: Greater weight loss was associated with more frequent discussions with healthcare providers, higher motivation and commitment to weight-loss efforts, and stronger family support. Cardiovascular disease and depression/anxiety were also independently associated with clinically significant weight loss. These findings identify factors associated with successful weight loss that warrant further investigation in longitudinal studies.
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(This article belongs to the Special Issue Obesity and Its Comorbidities: Prevention and Therapy 2026)
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Open AccessReview
Ultra-Processed Food Consumption and Obesity and Adiposity Among Young Adults: A Narrative Review of Recent Evidence
by
Juman Yaghi, Narmeen Al-Awwad and Reema Tayyem
Obesities 2026, 6(4), 45; https://doi.org/10.3390/obesities6040045 - 28 Jun 2026
Abstract
Ultra-processed foods (UPFs) are foods formulated through extensive industrial processing, with little or no natural food constituents, and include ingredients such as artificial colors, flavors, and other food additives to enhance shelf life and palatability. They are typically energy-dense and poor in essential
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Ultra-processed foods (UPFs) are foods formulated through extensive industrial processing, with little or no natural food constituents, and include ingredients such as artificial colors, flavors, and other food additives to enhance shelf life and palatability. They are typically energy-dense and poor in essential nutrients, including products such as sugar-sweetened beverages, packaged snacks, processed meats, instant noodles and confectioneries. UPF intake has been associated with a wide range of metabolic and inflammatory diseases, especially obesity and adiposity. The transition to independent living and increased dietary autonomy among young adults, particularly university students, are associated with higher reliance on UPF. This narrative review aims to examine the global evidence on the association between UPF consumption and obesity and adiposity outcomes among young adults. Most reviewed studies demonstrated a consistent positive association between UPF consumption and increased obesity and adiposity risks among young adults. UPF consumption within this population is substantial, ranging between 25% and 50% of total energy intake (TEI). The association between UPF consumption and increased risk of obesity and adiposity can be explained through multiple biological and behavioral mechanisms, including high energy density and palatability, disruption of satiety signaling, gut microbiota alterations, and hormonal dysregulation. To reduce the long-term burden of obesity among young adults, public efforts should be directed to important health interventions, such as university awareness nutritional programs, front-of-pack labeling, and policy-level restrictions on UPF marketing.
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(This article belongs to the Special Issue The Impact of Food Compounds on Obesity Mechanisms)
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Smoking, Central Obesity, and Periodontitis Among Iraqi Dental Patients: Exploring Metabolic-Behavioral Risk Clustering in a Cross-Sectional Study
by
Mohamed Saeed M. Ali, Omar Husham Ali and Hadeel Mazin Akram
Obesities 2026, 6(4), 44; https://doi.org/10.3390/obesities6040044 - 25 Jun 2026
Abstract
Smoking and central obesity have both been linked to periodontitis, but their combined relationship with periodontal disease may be influenced by demographic and behavioral factors. This cross-sectional study analyzed records of 420 adult dental patients attending the College of Dentistry at the University
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Smoking and central obesity have both been linked to periodontitis, but their combined relationship with periodontal disease may be influenced by demographic and behavioral factors. This cross-sectional study analyzed records of 420 adult dental patients attending the College of Dentistry at the University of Baghdad. Data included demographic characteristics, smoking status, periodontal clinical findings, body mass index (BMI), and waist-to-height ratio (WHtR). Periodontitis was defined according to the 2018 classification framework, and logistic regression models were used to examine the associations of smoking and obesity-related indicators with periodontitis. The overall prevalence of periodontitis was 36.4%. Participants with periodontitis were significantly older than those without periodontitis (46.0 vs. 28.9 years; p < 0.0001). In the fully adjusted model, age remained the strongest factor associated with periodontitis (OR = 1.15 per year; 95% CI: 1.11–1.18; p < 0.001). The apparent association between smoking and periodontitis was substantially influenced by age, as current smoking was more common among younger participants in this sample. The association between smoking status and periodontitis appeared to differ according to WHtR category (interaction term p = 0.016); however, this finding should be interpreted cautiously because of the cross-sectional design and age imbalance across exposure groups. Overall, the findings suggest that age was the dominant factor associated with periodontitis in this dental patient sample, while the relationship between smoking, central obesity, and periodontitis requires further investigation in longitudinal studies with detailed smoking and metabolic data.
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(This article belongs to the Topic Nutrition, Obesity and Metabolic Diseases)
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