Obesities Latest open access articles published in Obesities at https://www.mdpi.com/journal/obesities https://www.mdpi.com/journal/obesities MDPI en Creative Commons Attribution (CC-BY) MDPI support@mdpi.com Obesities, Vol. 6, Pages 28: When Training Is Not Enough: The Role of Relative Body Mass and Body Image in Predicting Eating Behaviours in Young Judo Athletes—A Companion Cross-Sectional Study https://www.mdpi.com/2673-4168/6/3/28 Judo, as a weight-category combat sport, exposes young athletes to body mass pressures that may foster abnormal eating behaviours. Building on a companion study that documented the prevalence and sex-specific characteristics of abnormal eating behaviours in this cohort, this secondary analysis aimed to identify training-related predictors of eating behaviours in young Polish judo athletes, examine body image satisfaction as a mediator, and assess whether patterns observed in elite adult athletes apply to younger populations. The participants were 150 athletes (70 girls, 80 boys) aged 12–17. Eating behaviours were assessed using the Three-Factor Eating Questionnaire (TFEQ-13) and the Test of Eating Situation Style (TSJ); training characteristics, pre-competition weight control, and appearance satisfaction were examined through hierarchical regression, mediation analysis, latent profile analysis, and two-way ANOVA. Training-related factors—including tenure, session frequency, competitive level, and pre-competition weight control—showed no significant associations with eating behaviours. However, in a subsample of N = 136 athletes, relative weight grouping predicted dietary restraint (p = 0.015, η2p = 0.066), with athletes in the heaviest tertile reporting higher restriction; lower appearance satisfaction was associated with greater restraint (p = 0.031, β = −0.192), independently of sport-mandated weight control; females demonstrated higher emotional eating across instruments (p < 0.001). These findings suggest that body image and weight classification may be more strongly associated with eating behaviours than training demands, highlighting the need for body image interventions and the monitoring of athletes near weight category boundaries. 2026-04-28 Obesities, Vol. 6, Pages 28: When Training Is Not Enough: The Role of Relative Body Mass and Body Image in Predicting Eating Behaviours in Young Judo Athletes—A Companion Cross-Sectional Study

Obesities doi: 10.3390/obesities6030028

Authors: Paulina Baran Katarzyna Szczepanik Łukasz Kapica Piotr Mamcarz

Judo, as a weight-category combat sport, exposes young athletes to body mass pressures that may foster abnormal eating behaviours. Building on a companion study that documented the prevalence and sex-specific characteristics of abnormal eating behaviours in this cohort, this secondary analysis aimed to identify training-related predictors of eating behaviours in young Polish judo athletes, examine body image satisfaction as a mediator, and assess whether patterns observed in elite adult athletes apply to younger populations. The participants were 150 athletes (70 girls, 80 boys) aged 12–17. Eating behaviours were assessed using the Three-Factor Eating Questionnaire (TFEQ-13) and the Test of Eating Situation Style (TSJ); training characteristics, pre-competition weight control, and appearance satisfaction were examined through hierarchical regression, mediation analysis, latent profile analysis, and two-way ANOVA. Training-related factors—including tenure, session frequency, competitive level, and pre-competition weight control—showed no significant associations with eating behaviours. However, in a subsample of N = 136 athletes, relative weight grouping predicted dietary restraint (p = 0.015, η2p = 0.066), with athletes in the heaviest tertile reporting higher restriction; lower appearance satisfaction was associated with greater restraint (p = 0.031, β = −0.192), independently of sport-mandated weight control; females demonstrated higher emotional eating across instruments (p < 0.001). These findings suggest that body image and weight classification may be more strongly associated with eating behaviours than training demands, highlighting the need for body image interventions and the monitoring of athletes near weight category boundaries.

]]> When Training Is Not Enough: The Role of Relative Body Mass and Body Image in Predicting Eating Behaviours in Young Judo Athletes—A Companion Cross-Sectional Study Paulina Baran Katarzyna Szczepanik Łukasz Kapica Piotr Mamcarz doi: 10.3390/obesities6030028 Obesities 2026-04-28 Obesities 2026-04-28 6 3 Article 28 10.3390/obesities6030028 https://www.mdpi.com/2673-4168/6/3/28 Obesities, Vol. 6, Pages 27: Towards Classifying Obesity Risk: A Cross-Validated XGBoost Model Optimized for Imbalanced Data https://www.mdpi.com/2673-4168/6/3/27 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. 2026-04-28 Obesities, Vol. 6, Pages 27: Towards Classifying Obesity Risk: A Cross-Validated XGBoost Model Optimized for Imbalanced Data

Obesities doi: 10.3390/obesities6030027

Authors: Jamal Haggouni Salma Azzouzi Moulay El Hassan Charaf

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.

]]> Towards Classifying Obesity Risk: A Cross-Validated XGBoost Model Optimized for Imbalanced Data Jamal Haggouni Salma Azzouzi Moulay El Hassan Charaf doi: 10.3390/obesities6030027 Obesities 2026-04-28 Obesities 2026-04-28 6 3 Article 27 10.3390/obesities6030027 https://www.mdpi.com/2673-4168/6/3/27 Obesities, Vol. 6, Pages 26: Exploring Psychological, Economic, and Cultural Factors Affecting Obesity by Sex: A Qualitative Analysis of Low-Income Participants in Southern Puerto Rico https://www.mdpi.com/2673-4168/6/3/26 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. 2026-04-24 Obesities, Vol. 6, Pages 26: Exploring Psychological, Economic, and Cultural Factors Affecting Obesity by Sex: A Qualitative Analysis of Low-Income Participants in Southern Puerto Rico

Obesities doi: 10.3390/obesities6030026

Authors: Andrés A. López-Cancel Jennifer Navas-Rosado David A. Vélez-Maldonado Jeannie Aguirre-Hernández Dorimar Rodríguez-Torruella Jorge L. Motta-Pagán Juan Derieux-Cruz Fernando J. Rosario-Maldonado Will Torres-Ruiz Delyris Rodríguez-Rodríguez Alannys García-Muriel Elizabeth Rivera-Mateo Luisa Morales-Torres Axel Ramos-Lucca Eida Castro-Figueroa Melissa Marzán-Rodríguez Julio Jiménez-Chávez

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.

]]> Exploring Psychological, Economic, and Cultural Factors Affecting Obesity by Sex: A Qualitative Analysis of Low-Income Participants in Southern Puerto Rico Andrés A. López-Cancel Jennifer Navas-Rosado David A. Vélez-Maldonado Jeannie Aguirre-Hernández Dorimar Rodríguez-Torruella Jorge L. Motta-Pagán Juan Derieux-Cruz Fernando J. Rosario-Maldonado Will Torres-Ruiz Delyris Rodríguez-Rodríguez Alannys García-Muriel Elizabeth Rivera-Mateo Luisa Morales-Torres Axel Ramos-Lucca Eida Castro-Figueroa Melissa Marzán-Rodríguez Julio Jiménez-Chávez doi: 10.3390/obesities6030026 Obesities 2026-04-24 Obesities 2026-04-24 6 3 Article 26 10.3390/obesities6030026 https://www.mdpi.com/2673-4168/6/3/26 Obesities, Vol. 6, Pages 25: Effects of Peru’s National School Feeding Program (Qali Warma) on Overweight and Obesity Among Children Aged 36–59 Months https://www.mdpi.com/2673-4168/6/3/25 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. 2026-04-22 Obesities, Vol. 6, Pages 25: Effects of Peru’s National School Feeding Program (Qali Warma) on Overweight and Obesity Among Children Aged 36–59 Months

Obesities doi: 10.3390/obesities6030025

Authors: Pedro Francke Gustavo Acosta Diego Quispe

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.

]]> Effects of Peru’s National School Feeding Program (Qali Warma) on Overweight and Obesity Among Children Aged 36–59 Months Pedro Francke Gustavo Acosta Diego Quispe doi: 10.3390/obesities6030025 Obesities 2026-04-22 Obesities 2026-04-22 6 3 Article 25 10.3390/obesities6030025 https://www.mdpi.com/2673-4168/6/3/25 Obesities, Vol. 6, Pages 24: Dietary Habits Contributing to Weight Gain Among a Random Sample of Undergraduate College Males https://www.mdpi.com/2673-4168/6/2/24 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. 2026-04-17 Obesities, Vol. 6, Pages 24: Dietary Habits Contributing to Weight Gain Among a Random Sample of Undergraduate College Males

Obesities doi: 10.3390/obesities6020024

Authors: Cedric Harville Delores C. S. James Sobit Regmi

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.

]]> Dietary Habits Contributing to Weight Gain Among a Random Sample of Undergraduate College Males Cedric Harville Delores C. S. James Sobit Regmi doi: 10.3390/obesities6020024 Obesities 2026-04-17 Obesities 2026-04-17 6 2 Article 24 10.3390/obesities6020024 https://www.mdpi.com/2673-4168/6/2/24 Obesities, Vol. 6, Pages 23: Active Breaks in School Settings and Their Impact on Children and Adolescents’ Lifestyle and Obesity-Related Behaviors: A Narrative Review https://www.mdpi.com/2673-4168/6/2/23 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. 2026-04-15 Obesities, Vol. 6, Pages 23: Active Breaks in School Settings and Their Impact on Children and Adolescents’ Lifestyle and Obesity-Related Behaviors: A Narrative Review

Obesities doi: 10.3390/obesities6020023

Authors: Domenico Martone Enzo Iuliano Johnny Padulo

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.

]]> Active Breaks in School Settings and Their Impact on Children and Adolescents’ Lifestyle and Obesity-Related Behaviors: A Narrative Review Domenico Martone Enzo Iuliano Johnny Padulo doi: 10.3390/obesities6020023 Obesities 2026-04-15 Obesities 2026-04-15 6 2 Review 23 10.3390/obesities6020023 https://www.mdpi.com/2673-4168/6/2/23 Obesities, Vol. 6, Pages 22: Cinnamon Supplementation Improves Uric Acid Levels in Adolescents with Obesity: Secondary Metabolic Outcomes from a Randomized Controlled Trial https://www.mdpi.com/2673-4168/6/2/22 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. 2026-04-13 Obesities, Vol. 6, Pages 22: Cinnamon Supplementation Improves Uric Acid Levels in Adolescents with Obesity: Secondary Metabolic Outcomes from a Randomized Controlled Trial

Obesities doi: 10.3390/obesities6020022

Authors: Nancy Lucero Martinez-Rodriguez Jessie Nallely Zurita-Cruz Israel Parra-Ortega Jenny Vilchis-Gil Miguel Angel Villasis-Keever Juan Manuel Dominguez-Salgado

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.

]]> Cinnamon Supplementation Improves Uric Acid Levels in Adolescents with Obesity: Secondary Metabolic Outcomes from a Randomized Controlled Trial Nancy Lucero Martinez-Rodriguez Jessie Nallely Zurita-Cruz Israel Parra-Ortega Jenny Vilchis-Gil Miguel Angel Villasis-Keever Juan Manuel Dominguez-Salgado doi: 10.3390/obesities6020022 Obesities 2026-04-13 Obesities 2026-04-13 6 2 Article 22 10.3390/obesities6020022 https://www.mdpi.com/2673-4168/6/2/22 Obesities, Vol. 6, Pages 21: Joint Associations of Sleep Quality, Mediterranean Diet, and Physical Activity with Central and Visceral Adiposity in 88,343 Spanish Workers https://www.mdpi.com/2673-4168/6/2/21 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. 2026-04-05 Obesities, Vol. 6, Pages 21: Joint Associations of Sleep Quality, Mediterranean Diet, and Physical Activity with Central and Visceral Adiposity in 88,343 Spanish Workers

Obesities doi: 10.3390/obesities6020021

Authors: Laura López Velasco Pedro Juan Tárraga López Ángel Arturo López-González Carla Busquets-Cortés María Teófila Vicente Herrero Joan Obrador de Hevia José Ignacio Ramírez-Manent

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.

]]> Joint Associations of Sleep Quality, Mediterranean Diet, and Physical Activity with Central and Visceral Adiposity in 88,343 Spanish Workers Laura López Velasco Pedro Juan Tárraga López Ángel Arturo López-González Carla Busquets-Cortés María Teófila Vicente Herrero Joan Obrador de Hevia José Ignacio Ramírez-Manent doi: 10.3390/obesities6020021 Obesities 2026-04-05 Obesities 2026-04-05 6 2 Article 21 10.3390/obesities6020021 https://www.mdpi.com/2673-4168/6/2/21 Obesities, Vol. 6, Pages 20: Current Body Mass Index Is Associated with Reported Weight Gain as a Reason for Discontinuing Oral Contraceptive Pill Use https://www.mdpi.com/2673-4168/6/2/20 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. 2026-03-29 Obesities, Vol. 6, Pages 20: Current Body Mass Index Is Associated with Reported Weight Gain as a Reason for Discontinuing Oral Contraceptive Pill Use

Obesities doi: 10.3390/obesities6020020

Authors: Adnin Zaman Myla Strawderman Susan W. Groth Barbara Lohse Wendy Vitek Roland J. Thorpe Elizabeth Heitman

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.

]]> Current Body Mass Index Is Associated with Reported Weight Gain as a Reason for Discontinuing Oral Contraceptive Pill Use Adnin Zaman Myla Strawderman Susan W. Groth Barbara Lohse Wendy Vitek Roland J. Thorpe Elizabeth Heitman doi: 10.3390/obesities6020020 Obesities 2026-03-29 Obesities 2026-03-29 6 2 Article 20 10.3390/obesities6020020 https://www.mdpi.com/2673-4168/6/2/20 Obesities, Vol. 6, Pages 19: Applying AI Tools for Monitoring Nutrition and Physical Activity in Populations with Obesity: Are We Ready? https://www.mdpi.com/2673-4168/6/2/19 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. 2026-03-27 Obesities, Vol. 6, Pages 19: Applying AI Tools for Monitoring Nutrition and Physical Activity in Populations with Obesity: Are We Ready?

Obesities doi: 10.3390/obesities6020019

Authors: Alessandra Amato Sara Baldassano Giuseppe Musumeci

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.

]]> Applying AI Tools for Monitoring Nutrition and Physical Activity in Populations with Obesity: Are We Ready? Alessandra Amato Sara Baldassano Giuseppe Musumeci doi: 10.3390/obesities6020019 Obesities 2026-03-27 Obesities 2026-03-27 6 2 Review 19 10.3390/obesities6020019 https://www.mdpi.com/2673-4168/6/2/19 Obesities, Vol. 6, Pages 18: Expert Consensus on the Appropriateness of Saccharomyces cerevisiae Hydrolysate in Obesity Management Using the RAND/UCLA Appropriateness Method https://www.mdpi.com/2673-4168/6/2/18 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. 2026-03-26 Obesities, Vol. 6, Pages 18: Expert Consensus on the Appropriateness of Saccharomyces cerevisiae Hydrolysate in Obesity Management Using the RAND/UCLA Appropriateness Method

Obesities doi: 10.3390/obesities6020018

Authors: Jorge Yamamoto Coralys Abreu-Rosario Ramón Arellano Cesar Ochoa-Martínez Ariana Morales José Héctor Sánchez-Mijangos Jorge Vázquez-García Rafael Violante-Ortiz Paola Zarza Berenice Cerón-Trujillo Edgar Ramírez-Ramírez Juan Carlos Castillo-Salinas Alberto Agustín Palacios-García

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.

]]> Expert Consensus on the Appropriateness of Saccharomyces cerevisiae Hydrolysate in Obesity Management Using the RAND/UCLA Appropriateness Method Jorge Yamamoto Coralys Abreu-Rosario Ramón Arellano Cesar Ochoa-Martínez Ariana Morales José Héctor Sánchez-Mijangos Jorge Vázquez-García Rafael Violante-Ortiz Paola Zarza Berenice Cerón-Trujillo Edgar Ramírez-Ramírez Juan Carlos Castillo-Salinas Alberto Agustín Palacios-García doi: 10.3390/obesities6020018 Obesities 2026-03-26 Obesities 2026-03-26 6 2 Article 18 10.3390/obesities6020018 https://www.mdpi.com/2673-4168/6/2/18 Obesities, Vol. 6, Pages 17: Sociodemographic, Dietary, and Lifestyle Factors Associated with Overweight and Obesity Among Young Industrial Workers in Vietnam https://www.mdpi.com/2673-4168/6/2/17 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. 2026-03-22 Obesities, Vol. 6, Pages 17: Sociodemographic, Dietary, and Lifestyle Factors Associated with Overweight and Obesity Among Young Industrial Workers in Vietnam

Obesities doi: 10.3390/obesities6020017

Authors: Thi Thu Lieu Nguyen Huy Duc Do Quan Thi Pham Xuan Thi Thanh Le Huong Thi Le Le Minh Giang

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.

]]> Sociodemographic, Dietary, and Lifestyle Factors Associated with Overweight and Obesity Among Young Industrial Workers in Vietnam Thi Thu Lieu Nguyen Huy Duc Do Quan Thi Pham Xuan Thi Thanh Le Huong Thi Le Le Minh Giang doi: 10.3390/obesities6020017 Obesities 2026-03-22 Obesities 2026-03-22 6 2 Article 17 10.3390/obesities6020017 https://www.mdpi.com/2673-4168/6/2/17 Obesities, Vol. 6, Pages 16: Early Cardiovascular Risk Indicators in School-Aged Children from Inland Portugal: Elevated Blood Pressure at Screening and the Coexistence of Underweight and Excess Weight https://www.mdpi.com/2673-4168/6/2/16 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. 2026-03-17 Obesities, Vol. 6, Pages 16: Early Cardiovascular Risk Indicators in School-Aged Children from Inland Portugal: Elevated Blood Pressure at Screening and the Coexistence of Underweight and Excess Weight

Obesities doi: 10.3390/obesities6020016

Authors: Patrícia Coelho Ana Figueiredo Sónia Mateus Guilherme Eustáquio Furtado Francisco José Barbas Rodrigues

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.

]]> Early Cardiovascular Risk Indicators in School-Aged Children from Inland Portugal: Elevated Blood Pressure at Screening and the Coexistence of Underweight and Excess Weight Patrícia Coelho Ana Figueiredo Sónia Mateus Guilherme Eustáquio Furtado Francisco José Barbas Rodrigues doi: 10.3390/obesities6020016 Obesities 2026-03-17 Obesities 2026-03-17 6 2 Article 16 10.3390/obesities6020016 https://www.mdpi.com/2673-4168/6/2/16 Obesities, Vol. 6, Pages 15: Honey Responders and Non-Responders in Individuals with Overweight and Obesity: A Pilot Study in Precision Nutrition https://www.mdpi.com/2673-4168/6/2/15 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. 2026-03-17 Obesities, Vol. 6, Pages 15: Honey Responders and Non-Responders in Individuals with Overweight and Obesity: A Pilot Study in Precision Nutrition

Obesities doi: 10.3390/obesities6020015

Authors: Xingzhi Li Weiwen Chai Sarah M. Eaton Olivier Munezero Lisa Whisenhunt Heather E. Rasmussen Sathish Kumar Natarajan Michael J. Naldrett Sophie Alvarez Samodha C. Fernando Jiujiu Yu

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.

]]> Honey Responders and Non-Responders in Individuals with Overweight and Obesity: A Pilot Study in Precision Nutrition Xingzhi Li Weiwen Chai Sarah M. Eaton Olivier Munezero Lisa Whisenhunt Heather E. Rasmussen Sathish Kumar Natarajan Michael J. Naldrett Sophie Alvarez Samodha C. Fernando Jiujiu Yu doi: 10.3390/obesities6020015 Obesities 2026-03-17 Obesities 2026-03-17 6 2 Article 15 10.3390/obesities6020015 https://www.mdpi.com/2673-4168/6/2/15 Obesities, Vol. 6, Pages 14: Normal Weight Obesity and Grip Strength: A Cross-Sectional Study https://www.mdpi.com/2673-4168/6/1/14 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. 2026-02-21 Obesities, Vol. 6, Pages 14: Normal Weight Obesity and Grip Strength: A Cross-Sectional Study

Obesities doi: 10.3390/obesities6010014

Authors: Neri Alvarez-Villalobos Carlos Porras-Barrientos Gabriela Elizondo-Omaña Alejandro Burciaga-Muñoz

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.

]]> Normal Weight Obesity and Grip Strength: A Cross-Sectional Study Neri Alvarez-Villalobos Carlos Porras-Barrientos Gabriela Elizondo-Omaña Alejandro Burciaga-Muñoz doi: 10.3390/obesities6010014 Obesities 2026-02-21 Obesities 2026-02-21 6 1 Article 14 10.3390/obesities6010014 https://www.mdpi.com/2673-4168/6/1/14 Obesities, Vol. 6, Pages 13: Rhinorrhea and Hiccups After Bariatric Surgery: Exploring Associations with Psychological and Behavioral Factors https://www.mdpi.com/2673-4168/6/1/13 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. 2026-02-08 Obesities, Vol. 6, Pages 13: Rhinorrhea and Hiccups After Bariatric Surgery: Exploring Associations with Psychological and Behavioral Factors

Obesities doi: 10.3390/obesities6010013

Authors: Marcello Agosta Maria Sofia Simona Santonocito Sara D’Amato Chiara Mazzone Cristina Agata Ranno Salvatore Camiolo Gaetano La Greca Saverio Latteri

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.

]]> Rhinorrhea and Hiccups After Bariatric Surgery: Exploring Associations with Psychological and Behavioral Factors Marcello Agosta Maria Sofia Simona Santonocito Sara D’Amato Chiara Mazzone Cristina Agata Ranno Salvatore Camiolo Gaetano La Greca Saverio Latteri doi: 10.3390/obesities6010013 Obesities 2026-02-08 Obesities 2026-02-08 6 1 Article 13 10.3390/obesities6010013 https://www.mdpi.com/2673-4168/6/1/13 Obesities, Vol. 6, Pages 12: Vitamin D in Obesity: Mechanisms and Clinical Impact https://www.mdpi.com/2673-4168/6/1/12 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. 2026-02-06 Obesities, Vol. 6, Pages 12: Vitamin D in Obesity: Mechanisms and Clinical Impact

Obesities doi: 10.3390/obesities6010012

Authors: Jitka Jirků Zuzana Kršáková Jarmila Křížová

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.

]]> Vitamin D in Obesity: Mechanisms and Clinical Impact Jitka Jirků Zuzana Kršáková Jarmila Křížová doi: 10.3390/obesities6010012 Obesities 2026-02-06 Obesities 2026-02-06 6 1 Review 12 10.3390/obesities6010012 https://www.mdpi.com/2673-4168/6/1/12 Obesities, Vol. 6, Pages 11: Psychological Predictors of Poor Weight Loss Following Endoscopic Sleeve Gastroplasty https://www.mdpi.com/2673-4168/6/1/11 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. 2026-02-06 Obesities, Vol. 6, Pages 11: Psychological Predictors of Poor Weight Loss Following Endoscopic Sleeve Gastroplasty

Obesities doi: 10.3390/obesities6010011

Authors: Lino Polese Sami Schiff Francesca Moltrer Anna Chiara Frigo Luca Prevedello Giulia Pozza Alice Albanese Sabrina Rampado Alessandro Scarda Silvia Bettini Paola Fioretto Mirto Foletto

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.

]]> Psychological Predictors of Poor Weight Loss Following Endoscopic Sleeve Gastroplasty Lino Polese Sami Schiff Francesca Moltrer Anna Chiara Frigo Luca Prevedello Giulia Pozza Alice Albanese Sabrina Rampado Alessandro Scarda Silvia Bettini Paola Fioretto Mirto Foletto doi: 10.3390/obesities6010011 Obesities 2026-02-06 Obesities 2026-02-06 6 1 Article 11 10.3390/obesities6010011 https://www.mdpi.com/2673-4168/6/1/11 Obesities, Vol. 6, Pages 10: Pediatric Use of Compounded GLP-1 Agents: Benefits, Risks, and Equity https://www.mdpi.com/2673-4168/6/1/10 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. 2026-02-05 Obesities, Vol. 6, Pages 10: Pediatric Use of Compounded GLP-1 Agents: Benefits, Risks, and Equity

Obesities doi: 10.3390/obesities6010010

Authors: Lisa Kelly Robert Siegel Elizabeth Lanphier

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.

]]> Pediatric Use of Compounded GLP-1 Agents: Benefits, Risks, and Equity Lisa Kelly Robert Siegel Elizabeth Lanphier doi: 10.3390/obesities6010010 Obesities 2026-02-05 Obesities 2026-02-05 6 1 Opinion 10 10.3390/obesities6010010 https://www.mdpi.com/2673-4168/6/1/10 Obesities, Vol. 6, Pages 9: From Prevention to Improvement: Impact of Rigorous Follow-Up on Post-Bariatric Nutritional and Metabolic Status https://www.mdpi.com/2673-4168/6/1/9 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. 2026-02-03 Obesities, Vol. 6, Pages 9: From Prevention to Improvement: Impact of Rigorous Follow-Up on Post-Bariatric Nutritional and Metabolic Status

Obesities doi: 10.3390/obesities6010009

Authors: Marcello Agosta Maria Sofia Sara D’Amato Federica Latteri Giuseppe Nicolò Conti Martina Bellissimo Chiara Mazzone Gaetano La Greca Saverio Latteri

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.

]]> From Prevention to Improvement: Impact of Rigorous Follow-Up on Post-Bariatric Nutritional and Metabolic Status Marcello Agosta Maria Sofia Sara D’Amato Federica Latteri Giuseppe Nicolò Conti Martina Bellissimo Chiara Mazzone Gaetano La Greca Saverio Latteri doi: 10.3390/obesities6010009 Obesities 2026-02-03 Obesities 2026-02-03 6 1 Article 9 10.3390/obesities6010009 https://www.mdpi.com/2673-4168/6/1/9 Obesities, Vol. 6, Pages 8: Relationship Between Weight Loss and Changes in Oral Function Test Results over 1 Year https://www.mdpi.com/2673-4168/6/1/8 Weight loss is an indicator of nutritional disorders, is associated with increased morbidity and mortality, and is more likely to be experienced by individuals with fewer teeth. In this study, we examined the relationship between 1-year body weight changes and variations in various oral function tests. In total, we examined 104 individuals aged 45–84 years (70 men and 34 women) who underwent health check-ups at our hospital in 2023 and 2024. Several oral function tests were performed, and changes over a 1-year period were compared using the Wilcoxon signed-rank test. The rate of change in oral function was compared between individuals who lost ≥5% of their body weight in 1 year and those who did not; no significant differences in body weight and oral function were observed between 2023 and 2024, and no significant differences in the rates of change in oral function or weight loss were observed based on sex and age. The rates of change in occlusal force and masticatory function were significantly correlated with weight loss rates, while no differences were observed in terms of sex or age between those who lost ≥5% of their body weight in 1 year and those who did not; the only significant difference was in occlusal force: weight loss was correlated with occlusal force over 1 year, with individuals who lost ≥5% of their body weight exhibiting significantly lower occlusal force, a risk factor for nutritional disorders. 2026-01-17 Obesities, Vol. 6, Pages 8: Relationship Between Weight Loss and Changes in Oral Function Test Results over 1 Year

Obesities doi: 10.3390/obesities6010008

Authors: Ryoko Igashira Miyuki Yokoi Mieko Okamoto Hitomi Sasaki Mitsuyoshi Yoshida

Weight loss is an indicator of nutritional disorders, is associated with increased morbidity and mortality, and is more likely to be experienced by individuals with fewer teeth. In this study, we examined the relationship between 1-year body weight changes and variations in various oral function tests. In total, we examined 104 individuals aged 45–84 years (70 men and 34 women) who underwent health check-ups at our hospital in 2023 and 2024. Several oral function tests were performed, and changes over a 1-year period were compared using the Wilcoxon signed-rank test. The rate of change in oral function was compared between individuals who lost ≥5% of their body weight in 1 year and those who did not; no significant differences in body weight and oral function were observed between 2023 and 2024, and no significant differences in the rates of change in oral function or weight loss were observed based on sex and age. The rates of change in occlusal force and masticatory function were significantly correlated with weight loss rates, while no differences were observed in terms of sex or age between those who lost ≥5% of their body weight in 1 year and those who did not; the only significant difference was in occlusal force: weight loss was correlated with occlusal force over 1 year, with individuals who lost ≥5% of their body weight exhibiting significantly lower occlusal force, a risk factor for nutritional disorders.

]]> Relationship Between Weight Loss and Changes in Oral Function Test Results over 1 Year Ryoko Igashira Miyuki Yokoi Mieko Okamoto Hitomi Sasaki Mitsuyoshi Yoshida doi: 10.3390/obesities6010008 Obesities 2026-01-17 Obesities 2026-01-17 6 1 Article 8 10.3390/obesities6010008 https://www.mdpi.com/2673-4168/6/1/8 Obesities, Vol. 6, Pages 7: Body Composition and Bone Status Through Lifespan in a Greek Adult Population: Establishing Reference Curves https://www.mdpi.com/2673-4168/6/1/7 Background/Objectives: Comprehensive knowledge of body composition and bone status across the lifespan is critical for clinical evaluation and public health initiatives. This study aimed to develop age- and sex-specific reference curves for body composition and bone status in a physically active Greek population aged 18–80 using dual-energy X-ray absorptiometry (DXA). A secondary objective was to examine age- and sex-related trends in fat distribution, lean mass (LM), and bone status. Methods: A cross-sectional analysis was conducted on 637 participants (275 men and 362 women). Physical activity was assessed through structured interviews evaluating type, frequency, and intensity, categorized using established guidelines from organizations such as the American Heart Association and World Health Organization. Anthropometric data and DXA scans were utilized to measure parameters including fat mass (FM), LM, and BMD. Participants were stratified into age categories, and percentile curves were generated using generalized additive models for location, scale, and shape (GAMLSS). Results: Among women, body mass increased by 20.9% and body fat percentage rose by 38.3% from the youngest to the oldest age group, accompanied by a 5.7% reduction in bone mineral density (BMD) and an 11.5% decline in bone mineral content (BMC). Men exhibited a 49.1% increase in body fat percentage, with LM remaining stable across age groups. In men, BMD decreased by 1.7%, while BMC showed minimal variation. Notable sex differences were observed in fat redistribution, with android fat (AF) increasing significantly in older individuals, particularly among women, highlighting distinct age-related patterns. Conclusions: This study provides essential reference data on body composition and bone status, emphasizing the need for tailored interventions to address sex- and age-related changes, particularly in fat distribution and bone density, to support improved health outcomes in aging populations. 2026-01-16 Obesities, Vol. 6, Pages 7: Body Composition and Bone Status Through Lifespan in a Greek Adult Population: Establishing Reference Curves

Obesities doi: 10.3390/obesities6010007

Authors: Dimitrios Balampanos Dimitrios Pantazis Alexandra Avloniti Theodoros Stampoulis Christos Kokkotis Anastasia Gkachtsou Stavros Kallidis Maria Protopapa Nikolaos-Orestis Retzepis Maria Emmanouilidou Junshi Liu Dimitrios Ioannou Stelios Kyriazidis Nikolaos Zaras Dimitrios Draganidis Ioannis Fatouros Antonis Kambas Maria Michalopoulou Athanasios Chatzinikolaou

Background/Objectives: Comprehensive knowledge of body composition and bone status across the lifespan is critical for clinical evaluation and public health initiatives. This study aimed to develop age- and sex-specific reference curves for body composition and bone status in a physically active Greek population aged 18–80 using dual-energy X-ray absorptiometry (DXA). A secondary objective was to examine age- and sex-related trends in fat distribution, lean mass (LM), and bone status. Methods: A cross-sectional analysis was conducted on 637 participants (275 men and 362 women). Physical activity was assessed through structured interviews evaluating type, frequency, and intensity, categorized using established guidelines from organizations such as the American Heart Association and World Health Organization. Anthropometric data and DXA scans were utilized to measure parameters including fat mass (FM), LM, and BMD. Participants were stratified into age categories, and percentile curves were generated using generalized additive models for location, scale, and shape (GAMLSS). Results: Among women, body mass increased by 20.9% and body fat percentage rose by 38.3% from the youngest to the oldest age group, accompanied by a 5.7% reduction in bone mineral density (BMD) and an 11.5% decline in bone mineral content (BMC). Men exhibited a 49.1% increase in body fat percentage, with LM remaining stable across age groups. In men, BMD decreased by 1.7%, while BMC showed minimal variation. Notable sex differences were observed in fat redistribution, with android fat (AF) increasing significantly in older individuals, particularly among women, highlighting distinct age-related patterns. Conclusions: This study provides essential reference data on body composition and bone status, emphasizing the need for tailored interventions to address sex- and age-related changes, particularly in fat distribution and bone density, to support improved health outcomes in aging populations.

]]> Body Composition and Bone Status Through Lifespan in a Greek Adult Population: Establishing Reference Curves Dimitrios Balampanos Dimitrios Pantazis Alexandra Avloniti Theodoros Stampoulis Christos Kokkotis Anastasia Gkachtsou Stavros Kallidis Maria Protopapa Nikolaos-Orestis Retzepis Maria Emmanouilidou Junshi Liu Dimitrios Ioannou Stelios Kyriazidis Nikolaos Zaras Dimitrios Draganidis Ioannis Fatouros Antonis Kambas Maria Michalopoulou Athanasios Chatzinikolaou doi: 10.3390/obesities6010007 Obesities 2026-01-16 Obesities 2026-01-16 6 1 Article 7 10.3390/obesities6010007 https://www.mdpi.com/2673-4168/6/1/7 Obesities, Vol. 6, Pages 6: Gender Differences in the Outcomes of Laparoscopic Sleeve Gastrectomy (LSG) https://www.mdpi.com/2673-4168/6/1/6 Background: Identifying differences between genders regarding long-term surgical outcomes in bariatric surgeries may be important for optimizing their results. Objective: The current study evaluated mid-term gender-specific differences in patients undergoing laparoscopic sleeve gastrectomy (LSG). Methods: A retrospective cohort study was done in our university-based hospital, including patients who underwent laparoscopic Sleeve Gastrectomy (LSG) between January 2014 and December 2017. We compared demographics and clinical history (including BMI) before and after surgery, as well as the Bariatric Analysis and Reporting Outcome System (BAROS) and complications. Results: We enrolled 217 patients, 86 of whom were males (39.6%), with an average age of 52 ± 0.8 years. We observed no significant differences between males and females in minimal BMI attained (26.35 ± 4.9 vs. 25.9 ± 4.5 respectively, p = 0.56), total complications rate (p = 0.165), early post-op complication rate (p = 0.158), need for re-operation (p = 0.357), and BAROS score (p = 0.42). Conclusions: LSG outcomes were similar for male and female patients, as measured by BAROS, BMI reduction, and complication rates. Further studies are warranted; however, in the meantime, LSG can be offered to the entire population, regardless of gender-specific considerations. 2026-01-14 Obesities, Vol. 6, Pages 6: Gender Differences in the Outcomes of Laparoscopic Sleeve Gastrectomy (LSG)

Obesities doi: 10.3390/obesities6010006

Authors: Hadar Pinto Uri Netz Shahar Atias Itzhak Avital Ezeldin Abu-zeid Zvi H. Perry

Background: Identifying differences between genders regarding long-term surgical outcomes in bariatric surgeries may be important for optimizing their results. Objective: The current study evaluated mid-term gender-specific differences in patients undergoing laparoscopic sleeve gastrectomy (LSG). Methods: A retrospective cohort study was done in our university-based hospital, including patients who underwent laparoscopic Sleeve Gastrectomy (LSG) between January 2014 and December 2017. We compared demographics and clinical history (including BMI) before and after surgery, as well as the Bariatric Analysis and Reporting Outcome System (BAROS) and complications. Results: We enrolled 217 patients, 86 of whom were males (39.6%), with an average age of 52 ± 0.8 years. We observed no significant differences between males and females in minimal BMI attained (26.35 ± 4.9 vs. 25.9 ± 4.5 respectively, p = 0.56), total complications rate (p = 0.165), early post-op complication rate (p = 0.158), need for re-operation (p = 0.357), and BAROS score (p = 0.42). Conclusions: LSG outcomes were similar for male and female patients, as measured by BAROS, BMI reduction, and complication rates. Further studies are warranted; however, in the meantime, LSG can be offered to the entire population, regardless of gender-specific considerations.

]]> Gender Differences in the Outcomes of Laparoscopic Sleeve Gastrectomy (LSG) Hadar Pinto Uri Netz Shahar Atias Itzhak Avital Ezeldin Abu-zeid Zvi H. Perry doi: 10.3390/obesities6010006 Obesities 2026-01-14 Obesities 2026-01-14 6 1 Article 6 10.3390/obesities6010006 https://www.mdpi.com/2673-4168/6/1/6 Obesities, Vol. 6, Pages 5: Weight Fluctuations from Pregnancy Until 3 Years Postpartum: Timing and Goals for Women’s Weight Management https://www.mdpi.com/2673-4168/6/1/5 Background: The prevalence of being overweight and of obesity among women of childbearing age is constantly increasing. Objectives: To analyze the critical periods and goals of women’s weight management from early pregnancy to 3 years postpartum. Methods: Women’s weight was tracked from the first trimester of pregnancy to 3 years postpartum. We calculated their gestational weight gain (GWG) and postpartum weight retention (PPWR), and used linear mixed models and logistic models to estimate weight change velocities and risk factors associated with overweight/obesity at 1–3 years postpartum. Results: The medians of pre-pregnancy BMI (pre-BMI) and GWG among the 641 participants were 20.1 kg/m2 and 15.0 kg. Among women with pre-BMI < 24 kg/m2, those with excessive GWG remained at higher weights within 1.5 years postpartum than those with appropriate GWG (p < 0.05). Women’s weight decreased from 42 days to 1 year postpartum (β = −0.31 for low pre-BMI, β = −0.24 for normal pre-BMI, both p < 0.05), and remained unchanged from 1 to 3 years (p > 0.05). The rate of being overweight/obese at one year postpartum was mainly associated with pre-pregnancy weight (as a continuous variable, aOR = 1.58, 95%CI: 1.44–1.74) and 1-year PPWR (aOR = 1.78, 95%CI: 1.48–2.15). Compared with women who maintained normal BMI, those who shifted to being overweight/obese had higher pre-BMI and 1-year PPWR (22.6 kg/m2 vs. 20.3 kg/m2, 7.0 kg vs. 1.0 kg, p < 0.01). Conclusions: Normal and relatively low pre-BMI (18.5–22.0 kg/m2) and less than 2.0 kg of 1-year PPWR are goals of women’s weight management. 2026-01-12 Obesities, Vol. 6, Pages 5: Weight Fluctuations from Pregnancy Until 3 Years Postpartum: Timing and Goals for Women’s Weight Management

Obesities doi: 10.3390/obesities6010005

Authors: Xinyan Tan Jie Wang Zhenyu Yang Jiaping Tang Xuehong Pang Ye Wang

Background: The prevalence of being overweight and of obesity among women of childbearing age is constantly increasing. Objectives: To analyze the critical periods and goals of women’s weight management from early pregnancy to 3 years postpartum. Methods: Women’s weight was tracked from the first trimester of pregnancy to 3 years postpartum. We calculated their gestational weight gain (GWG) and postpartum weight retention (PPWR), and used linear mixed models and logistic models to estimate weight change velocities and risk factors associated with overweight/obesity at 1–3 years postpartum. Results: The medians of pre-pregnancy BMI (pre-BMI) and GWG among the 641 participants were 20.1 kg/m2 and 15.0 kg. Among women with pre-BMI < 24 kg/m2, those with excessive GWG remained at higher weights within 1.5 years postpartum than those with appropriate GWG (p < 0.05). Women’s weight decreased from 42 days to 1 year postpartum (β = −0.31 for low pre-BMI, β = −0.24 for normal pre-BMI, both p < 0.05), and remained unchanged from 1 to 3 years (p > 0.05). The rate of being overweight/obese at one year postpartum was mainly associated with pre-pregnancy weight (as a continuous variable, aOR = 1.58, 95%CI: 1.44–1.74) and 1-year PPWR (aOR = 1.78, 95%CI: 1.48–2.15). Compared with women who maintained normal BMI, those who shifted to being overweight/obese had higher pre-BMI and 1-year PPWR (22.6 kg/m2 vs. 20.3 kg/m2, 7.0 kg vs. 1.0 kg, p < 0.01). Conclusions: Normal and relatively low pre-BMI (18.5–22.0 kg/m2) and less than 2.0 kg of 1-year PPWR are goals of women’s weight management.

]]> Weight Fluctuations from Pregnancy Until 3 Years Postpartum: Timing and Goals for Women’s Weight Management Xinyan Tan Jie Wang Zhenyu Yang Jiaping Tang Xuehong Pang Ye Wang doi: 10.3390/obesities6010005 Obesities 2026-01-12 Obesities 2026-01-12 6 1 Article 5 10.3390/obesities6010005 https://www.mdpi.com/2673-4168/6/1/5 Obesities, Vol. 6, Pages 4: Effectiveness of Metformin in Preventing Type 2 Diabetes in Children and Adolescents with Overweight or Obesity: A Protocol for a Systematic Review and Meta-Analysis https://www.mdpi.com/2673-4168/6/1/4 Type 2 diabetes is increasingly prevalent among children and adolescents with overweight or obesity, and although lifestyle interventions remain first-line preventive strategies, long-term adherence and effectiveness are often limited. Metformin has demonstrated efficacy in delaying type 2 diabetes onset in adults at high risk, but its preventive role in pediatric populations remains unclear. This systematic review and meta-analysis aims to evaluate the effectiveness of metformin, alone or in combination with lifestyle interventions, in preventing or delaying type 2 diabetes among children and adolescents with overweight or obesity. The protocol is registered in PROSPERO (CRD42024615622), MEDLINE (PubMed), Embase, Cochrane Library, Scopus, and Web of Science and will be searched from inception to June 2025. Eligible studies include randomized controlled trials, quasi-experimental studies, and prospective cohort studies involving individuals under 18 years of age. The primary outcome is incidence of type 2 diabetes, with secondary outcomes including fasting plasma glucose, HbA1c, insulin resistance, BMI z-score, adherence, and adverse events. Where appropriate, random-effects meta-analyses will be conducted. This review will synthesize current evidence on metformin for pediatric type 2 diabetes prevention and inform future preventive strategies and clinical decision-making. 2026-01-10 Obesities, Vol. 6, Pages 4: Effectiveness of Metformin in Preventing Type 2 Diabetes in Children and Adolescents with Overweight or Obesity: A Protocol for a Systematic Review and Meta-Analysis

Obesities doi: 10.3390/obesities6010004

Authors: Neil Wills Neeki Derhami Aadya Makhija Hayley Patrick Ava Pourtousi Jade Asfour Liam McAlister Tiago Jeronimo dos Santos Marina Ybarra

Type 2 diabetes is increasingly prevalent among children and adolescents with overweight or obesity, and although lifestyle interventions remain first-line preventive strategies, long-term adherence and effectiveness are often limited. Metformin has demonstrated efficacy in delaying type 2 diabetes onset in adults at high risk, but its preventive role in pediatric populations remains unclear. This systematic review and meta-analysis aims to evaluate the effectiveness of metformin, alone or in combination with lifestyle interventions, in preventing or delaying type 2 diabetes among children and adolescents with overweight or obesity. The protocol is registered in PROSPERO (CRD42024615622), MEDLINE (PubMed), Embase, Cochrane Library, Scopus, and Web of Science and will be searched from inception to June 2025. Eligible studies include randomized controlled trials, quasi-experimental studies, and prospective cohort studies involving individuals under 18 years of age. The primary outcome is incidence of type 2 diabetes, with secondary outcomes including fasting plasma glucose, HbA1c, insulin resistance, BMI z-score, adherence, and adverse events. Where appropriate, random-effects meta-analyses will be conducted. This review will synthesize current evidence on metformin for pediatric type 2 diabetes prevention and inform future preventive strategies and clinical decision-making.

]]> Effectiveness of Metformin in Preventing Type 2 Diabetes in Children and Adolescents with Overweight or Obesity: A Protocol for a Systematic Review and Meta-Analysis Neil Wills Neeki Derhami Aadya Makhija Hayley Patrick Ava Pourtousi Jade Asfour Liam McAlister Tiago Jeronimo dos Santos Marina Ybarra doi: 10.3390/obesities6010004 Obesities 2026-01-10 Obesities 2026-01-10 6 1 Protocol 4 10.3390/obesities6010004 https://www.mdpi.com/2673-4168/6/1/4 Obesities, Vol. 6, Pages 3: Chronotype and Social Jetlag: Impacts on Nutritional Status and Dietary Intake of University Students https://www.mdpi.com/2673-4168/6/1/3 The circadian cycle regulates metabolism in response to external stimuli, such as light exposure, sleep schedules, and eating patterns. However, misalignment between internal biological rhythms and social demands can compromise food choices, potentially leading to overweight and obesity. This research aimed to assess how a person’s chronotype links to social jet lag (SJL), which in turn would relate to their nutritional status and food consumption patterns as a university student. 617 students from a State University located in the State of Paraná, Brazil, completed a cross-sectional research study that collected sociodemographic information/anthropometrics by means of an online survey. It included self-reported height/weight data and dietary habits. The Munich Chronotype Questionnaire (MCTQ) was utilized to determine each participant’s chronotype classification and SJL calculation. Researchers found that nearly half of the students (49.3%) displayed an Intermediate Chronotype, which is associated with a diet that contained elements of the “Mixed” Diet, meaning there are equal portions of healthy food (Fresh Fruits, Beans, etc.) and unhealthy foods (Sweetened Beverages). The multivariate logistic regression analyses identified age as a significant predictor of obesity risk (OR: 1.15, p < 0.001), while dietary habits such as fruit consumption played a protective role. Additionally, having a breakfast protected them from being classified as obese compared to those who did not eat breakfast (OR = 0.59). Contrary to expectations, late-night supper was not a statistically significant predictor in the adjusted model. Predictors of an Intermediate chronotype included being male and eating morning snacks regularly. The results of this study suggest that students with an intermediate chronotype will predictably have skewed eating patterns, such as skipping breakfast and eating late—both of which affect obesity risks. Nutritional strategies for university students should focus on promoting circadian regularity and optimizing meal timing. 2026-01-09 Obesities, Vol. 6, Pages 3: Chronotype and Social Jetlag: Impacts on Nutritional Status and Dietary Intake of University Students

Obesities doi: 10.3390/obesities6010003

Authors: Lyandra Deluchi Loch Gabriela Iber Correa Isabela Fernandes Araújo Amanda Portugal Gabriela Datsch Bennemann Caryna Eurich Mazur Guilherme Welter Wendt Lirane Elize Defante Ferreto Carolina Panis Camila Elizandra Rossi Kérley Braga Pereira Bento Casaril Gisele Arruda Léia Carolina Lucio Cleide Viviane Buzanello Geraldo Emílio Vicentini Claudiceia Risso Pascotto Aedra Carla Bufalo Kawassaki Ana Paula Vieira Dalila Moter Benvegnú Franciele Ani Caovilla Follador Mariana Abe Vicente Cavagnari

The circadian cycle regulates metabolism in response to external stimuli, such as light exposure, sleep schedules, and eating patterns. However, misalignment between internal biological rhythms and social demands can compromise food choices, potentially leading to overweight and obesity. This research aimed to assess how a person’s chronotype links to social jet lag (SJL), which in turn would relate to their nutritional status and food consumption patterns as a university student. 617 students from a State University located in the State of Paraná, Brazil, completed a cross-sectional research study that collected sociodemographic information/anthropometrics by means of an online survey. It included self-reported height/weight data and dietary habits. The Munich Chronotype Questionnaire (MCTQ) was utilized to determine each participant’s chronotype classification and SJL calculation. Researchers found that nearly half of the students (49.3%) displayed an Intermediate Chronotype, which is associated with a diet that contained elements of the “Mixed” Diet, meaning there are equal portions of healthy food (Fresh Fruits, Beans, etc.) and unhealthy foods (Sweetened Beverages). The multivariate logistic regression analyses identified age as a significant predictor of obesity risk (OR: 1.15, p < 0.001), while dietary habits such as fruit consumption played a protective role. Additionally, having a breakfast protected them from being classified as obese compared to those who did not eat breakfast (OR = 0.59). Contrary to expectations, late-night supper was not a statistically significant predictor in the adjusted model. Predictors of an Intermediate chronotype included being male and eating morning snacks regularly. The results of this study suggest that students with an intermediate chronotype will predictably have skewed eating patterns, such as skipping breakfast and eating late—both of which affect obesity risks. Nutritional strategies for university students should focus on promoting circadian regularity and optimizing meal timing.

]]> Chronotype and Social Jetlag: Impacts on Nutritional Status and Dietary Intake of University Students Lyandra Deluchi Loch Gabriela Iber Correa Isabela Fernandes Araújo Amanda Portugal Gabriela Datsch Bennemann Caryna Eurich Mazur Guilherme Welter Wendt Lirane Elize Defante Ferreto Carolina Panis Camila Elizandra Rossi Kérley Braga Pereira Bento Casaril Gisele Arruda Léia Carolina Lucio Cleide Viviane Buzanello Geraldo Emílio Vicentini Claudiceia Risso Pascotto Aedra Carla Bufalo Kawassaki Ana Paula Vieira Dalila Moter Benvegnú Franciele Ani Caovilla Follador Mariana Abe Vicente Cavagnari doi: 10.3390/obesities6010003 Obesities 2026-01-09 Obesities 2026-01-09 6 1 Article 3 10.3390/obesities6010003 https://www.mdpi.com/2673-4168/6/1/3 Obesities, Vol. 6, Pages 2: Patient Outcomes Under Varying Engagement Patterns on Real-World Lifestyle-Supported Pharmacological Weight-Loss Therapy https://www.mdpi.com/2673-4168/6/1/2 Overweight and obesity represent a significant global health challenge, requiring comprehensive, long-term approaches. Digital weight-loss services (DWLSs) have emerged as promising obesity care models, as they facilitate access to continuous multidisciplinary care. This study aimed to evaluate 12-month weight-loss and adherence patterns in a large unsubsidized DWLS in the UK, which combined lifestyle therapy with semaglutide treatment. A retrospective cohort design was used to analyze data from 7279 patients who initiated treatment between 1 January 2023, and 1 May 2024. Of these patients, 1678 (23.05%) met all criteria for inclusion in the efficacy estimand, which included receiving a minimum of 8 medication orders and submitting weight data within 341–379 days after program initiation. The efficacy estimand achieved a mean weight loss of 15.67%, with 92.49% losing a clinically meaningful amount of weight (≥5%). A strong positive association was found between weight tracking frequency and weight loss, to the extent that a percentage discrepancy of 8.41 points was observed between patients who tracked on less than 20 occasions (Median = 11.83%) and those who tracked at least 100 times (Median = 20.24%). A significant association between weight loss and semaglutide orders was also observed, with a clear distinction existing between patients who received less than 12 orders, and those who received 12 or more orders. Patients whose DWLS experience was supplemented with Wegovy recorded significantly higher mean weight loss than those who were treated with Ozempic (17.68% vs. 14.72%). The findings highlight the importance of program engagement in DWLS outcomes and suggest the need for a comparative analysis of unsubsidized and subsidized services. The study is limited by its real-world observational design and reliance on self-reported data; future research should compare outcomes between unsubsidized and subsidized DWLS cohorts. 2026-01-07 Obesities, Vol. 6, Pages 2: Patient Outcomes Under Varying Engagement Patterns on Real-World Lifestyle-Supported Pharmacological Weight-Loss Therapy

Obesities doi: 10.3390/obesities6010002

Authors: Louis Talay Gerónimo Petrel Neera Ahuja Amit Tiroshi

Overweight and obesity represent a significant global health challenge, requiring comprehensive, long-term approaches. Digital weight-loss services (DWLSs) have emerged as promising obesity care models, as they facilitate access to continuous multidisciplinary care. This study aimed to evaluate 12-month weight-loss and adherence patterns in a large unsubsidized DWLS in the UK, which combined lifestyle therapy with semaglutide treatment. A retrospective cohort design was used to analyze data from 7279 patients who initiated treatment between 1 January 2023, and 1 May 2024. Of these patients, 1678 (23.05%) met all criteria for inclusion in the efficacy estimand, which included receiving a minimum of 8 medication orders and submitting weight data within 341–379 days after program initiation. The efficacy estimand achieved a mean weight loss of 15.67%, with 92.49% losing a clinically meaningful amount of weight (≥5%). A strong positive association was found between weight tracking frequency and weight loss, to the extent that a percentage discrepancy of 8.41 points was observed between patients who tracked on less than 20 occasions (Median = 11.83%) and those who tracked at least 100 times (Median = 20.24%). A significant association between weight loss and semaglutide orders was also observed, with a clear distinction existing between patients who received less than 12 orders, and those who received 12 or more orders. Patients whose DWLS experience was supplemented with Wegovy recorded significantly higher mean weight loss than those who were treated with Ozempic (17.68% vs. 14.72%). The findings highlight the importance of program engagement in DWLS outcomes and suggest the need for a comparative analysis of unsubsidized and subsidized services. The study is limited by its real-world observational design and reliance on self-reported data; future research should compare outcomes between unsubsidized and subsidized DWLS cohorts.

]]> Patient Outcomes Under Varying Engagement Patterns on Real-World Lifestyle-Supported Pharmacological Weight-Loss Therapy Louis Talay Gerónimo Petrel Neera Ahuja Amit Tiroshi doi: 10.3390/obesities6010002 Obesities 2026-01-07 Obesities 2026-01-07 6 1 Article 2 10.3390/obesities6010002 https://www.mdpi.com/2673-4168/6/1/2 Obesities, Vol. 6, Pages 1: The Interplay Between Insulin Resistance, Affective Dysregulation, and Binge Eating in Obesity: Toward an Integrated Biopsychosocial Treatment Model https://www.mdpi.com/2673-4168/6/1/1 Background: Obesity is increasingly recognized as a complex condition characterized by the convergence of metabolic dysregulation and psychological vulnerability. Insulin resistance (IR) has been identified as a biological bridge linking metabolic imbalance with affective symptoms such as anxiety, depression, and disordered eating behaviors. Methods: Fifteen obese adults (mean age = 25 ± 4.3 years) were evaluated through clinical examination, anthropometric assessment (BMI), biochemical assays (fasting insulin, AST, ALT), and standardized psychological assessments (STAI, BDI-II). In parallel, a rapid systematic review (2019–2025) synthesized evidence on the association between IR, affective dysregulation, binge eating disorder (BED), and the clinical role of insulin-sensitizing or incretin-based therapies. Results: Participants exhibited marked hyperinsulinemia (M = 79 μU/mL, SD = 6.61) and elevated anxiety (STAI-Trait = 54.22 ± 22.4) and depression scores (BDI-II = 21.6 ± 7.5). Liver enzymes were within normal limits. Literature synthesis confirmed consistent associations between IR, mood symptoms, and BED, associated with biological processes including inflammation, HPA axis hyperactivity, and dopaminergic imbalance. Integrated treatment approaches combining cognitive-behavioral therapy, medical nutrition therapy, and insulin-sensitizing agents (metformin, GLP-1RA, and GLP-1/GIP RA) were supported as effective and safe options. Conclusions: The coexistence of insulin resistance and emotional dysregulation in obesity is consistent with the hypothesis of a bidirectional metabolic–emotional axis. Early, integrated interventions addressing both metabolic and psychological domains may improve clinical outcomes and reduce progression toward chronic metabolic and psychiatric comorbidity. 2026-01-03 Obesities, Vol. 6, Pages 1: The Interplay Between Insulin Resistance, Affective Dysregulation, and Binge Eating in Obesity: Toward an Integrated Biopsychosocial Treatment Model

Obesities doi: 10.3390/obesities6010001

Authors: Luna Carpinelli Carolina Amato Daniela Abate Marinelli Giovanna Stornaiuolo Giulia Savarese

Background: Obesity is increasingly recognized as a complex condition characterized by the convergence of metabolic dysregulation and psychological vulnerability. Insulin resistance (IR) has been identified as a biological bridge linking metabolic imbalance with affective symptoms such as anxiety, depression, and disordered eating behaviors. Methods: Fifteen obese adults (mean age = 25 ± 4.3 years) were evaluated through clinical examination, anthropometric assessment (BMI), biochemical assays (fasting insulin, AST, ALT), and standardized psychological assessments (STAI, BDI-II). In parallel, a rapid systematic review (2019–2025) synthesized evidence on the association between IR, affective dysregulation, binge eating disorder (BED), and the clinical role of insulin-sensitizing or incretin-based therapies. Results: Participants exhibited marked hyperinsulinemia (M = 79 μU/mL, SD = 6.61) and elevated anxiety (STAI-Trait = 54.22 ± 22.4) and depression scores (BDI-II = 21.6 ± 7.5). Liver enzymes were within normal limits. Literature synthesis confirmed consistent associations between IR, mood symptoms, and BED, associated with biological processes including inflammation, HPA axis hyperactivity, and dopaminergic imbalance. Integrated treatment approaches combining cognitive-behavioral therapy, medical nutrition therapy, and insulin-sensitizing agents (metformin, GLP-1RA, and GLP-1/GIP RA) were supported as effective and safe options. Conclusions: The coexistence of insulin resistance and emotional dysregulation in obesity is consistent with the hypothesis of a bidirectional metabolic–emotional axis. Early, integrated interventions addressing both metabolic and psychological domains may improve clinical outcomes and reduce progression toward chronic metabolic and psychiatric comorbidity.

]]> The Interplay Between Insulin Resistance, Affective Dysregulation, and Binge Eating in Obesity: Toward an Integrated Biopsychosocial Treatment Model Luna Carpinelli Carolina Amato Daniela Abate Marinelli Giovanna Stornaiuolo Giulia Savarese doi: 10.3390/obesities6010001 Obesities 2026-01-03 Obesities 2026-01-03 6 1 Article 1 10.3390/obesities6010001 https://www.mdpi.com/2673-4168/6/1/1 Obesities, Vol. 5, Pages 95: Is Crime Associated with Obesity and High Blood Pressure? Repeated Cross-Sectional Evidence from a Peruvian Study https://www.mdpi.com/2673-4168/5/4/95 Violence is an emerging social determinant of health in Latin America; however, empirical evidence from Peru remains limited. This study examined the association between crime rates and the prevalence of obesity and high blood pressure in Peru from 2019 to 2023. Using a repeated cross-sectional design with department–year aggregates, we analyzed nationally representative data from the Demographic and Family Health Survey, adjusting for sociodemographic, mental health, and geographic factors. Regional statistics on crime were incorporated into the analysis. The findings revealed a significant association between higher levels of crime and increased prevalence of self-reported high blood pressure and obesity. The association with obesity was particularly pronounced in border regions such as Tumbes, Madre de Dios, and Callao, where criminal activity is more prevalent. The findings indicate that prolonged exposure to violence may negatively impact biological stress responses, limit physical activity, and encourage the emergence of detrimental behaviors, consequently increasing the cardiometabolic risk burden in affected populations. 2025-12-17 Obesities, Vol. 5, Pages 95: Is Crime Associated with Obesity and High Blood Pressure? Repeated Cross-Sectional Evidence from a Peruvian Study

Obesities doi: 10.3390/obesities5040095

Authors: Rosmery Ramos-Sandoval Janina Bazalar Palacios Milagros Leonardo Ramos Emily Baca Marroquín Arelly Fernanda Vega Peche Nicolas Ismael Alayo Arias

Violence is an emerging social determinant of health in Latin America; however, empirical evidence from Peru remains limited. This study examined the association between crime rates and the prevalence of obesity and high blood pressure in Peru from 2019 to 2023. Using a repeated cross-sectional design with department–year aggregates, we analyzed nationally representative data from the Demographic and Family Health Survey, adjusting for sociodemographic, mental health, and geographic factors. Regional statistics on crime were incorporated into the analysis. The findings revealed a significant association between higher levels of crime and increased prevalence of self-reported high blood pressure and obesity. The association with obesity was particularly pronounced in border regions such as Tumbes, Madre de Dios, and Callao, where criminal activity is more prevalent. The findings indicate that prolonged exposure to violence may negatively impact biological stress responses, limit physical activity, and encourage the emergence of detrimental behaviors, consequently increasing the cardiometabolic risk burden in affected populations.

]]> Is Crime Associated with Obesity and High Blood Pressure? Repeated Cross-Sectional Evidence from a Peruvian Study Rosmery Ramos-Sandoval Janina Bazalar Palacios Milagros Leonardo Ramos Emily Baca Marroquín Arelly Fernanda Vega Peche Nicolas Ismael Alayo Arias doi: 10.3390/obesities5040095 Obesities 2025-12-17 Obesities 2025-12-17 5 4 Article 95 10.3390/obesities5040095 https://www.mdpi.com/2673-4168/5/4/95 Obesities, Vol. 5, Pages 94: Assessment of Dietary Protein Sources Among Post-Sleeve Gastrectomy Patients in Saudi Arabia https://www.mdpi.com/2673-4168/5/4/94 Obesity is a significant global health challenge, with prevalence rising steadily worldwide. Effective management often involves bariatric surgery, such as sleeve gastrectomy (SG), which has proven effective in reducing weight and improving comorbid conditions. This study aimed to evaluate nutritional status and protein source awareness and its impact on muscle mass among patients post SG surgery in Saudi Arabia. A cross-sectional study was conducted among 98 adults (aged 18–51 years) who underwent SG at the Department of Metabolic and Bariatric Surgery (Badana Clinic)/Mouwasat Hospital in Dammam from December 2023 to February 2024. Data were collected using an electronic questionnaire that covered demographics, dietary habits, physical activity, protein knowledge (from food and supplements), and a 24 h dietary recall. Body composition, including muscle mass, was assessed using the InBody270 Body Composition Analyzer. The results revealed that participants exhibited a high level of awareness regarding the importance of protein sources. However, muscle mass decreased by an average of 4.11 kg after surgery. This decline was attributed to insufficient protein intake, which ranged between 30 and 60 g per day, below recommended levels. Taste aversion and dietary limitations post-surgery contributed to this inadequate protein consumption. In conclusion, while participants understood the significance of protein for muscle maintenance, practical challenges in achieving adequate protein sources led to muscle mass loss. These findings underscore the importance of tailored nutritional strategies and education to optimize recovery and long-term health outcomes for SG surgery patients. 2025-12-16 Obesities, Vol. 5, Pages 94: Assessment of Dietary Protein Sources Among Post-Sleeve Gastrectomy Patients in Saudi Arabia

Obesities doi: 10.3390/obesities5040094

Authors: Mashael T. Kharnoub Randah M. Alqurashi Samar M. Abdalla Sultan Al Temyatt

Obesity is a significant global health challenge, with prevalence rising steadily worldwide. Effective management often involves bariatric surgery, such as sleeve gastrectomy (SG), which has proven effective in reducing weight and improving comorbid conditions. This study aimed to evaluate nutritional status and protein source awareness and its impact on muscle mass among patients post SG surgery in Saudi Arabia. A cross-sectional study was conducted among 98 adults (aged 18–51 years) who underwent SG at the Department of Metabolic and Bariatric Surgery (Badana Clinic)/Mouwasat Hospital in Dammam from December 2023 to February 2024. Data were collected using an electronic questionnaire that covered demographics, dietary habits, physical activity, protein knowledge (from food and supplements), and a 24 h dietary recall. Body composition, including muscle mass, was assessed using the InBody270 Body Composition Analyzer. The results revealed that participants exhibited a high level of awareness regarding the importance of protein sources. However, muscle mass decreased by an average of 4.11 kg after surgery. This decline was attributed to insufficient protein intake, which ranged between 30 and 60 g per day, below recommended levels. Taste aversion and dietary limitations post-surgery contributed to this inadequate protein consumption. In conclusion, while participants understood the significance of protein for muscle maintenance, practical challenges in achieving adequate protein sources led to muscle mass loss. These findings underscore the importance of tailored nutritional strategies and education to optimize recovery and long-term health outcomes for SG surgery patients.

]]> Assessment of Dietary Protein Sources Among Post-Sleeve Gastrectomy Patients in Saudi Arabia Mashael T. Kharnoub Randah M. Alqurashi Samar M. Abdalla Sultan Al Temyatt doi: 10.3390/obesities5040094 Obesities 2025-12-16 Obesities 2025-12-16 5 4 Article 94 10.3390/obesities5040094 https://www.mdpi.com/2673-4168/5/4/94 Obesities, Vol. 5, Pages 93: Anthropometric Indicators of Obesity as Screening Tools for Hypertriglyceridemia in Older Adults: A Cross-Sectional Study https://www.mdpi.com/2673-4168/5/4/93 Background: Hypertriglyceridemia is a lipid disorder characterized by elevated plasma triglyceride levels, and its prevalence increases with aging. This condition contributes substantially to morbidity and mortality in older adults. In settings with limited access to laboratory testing, especially in developing countries such as Brazil, identifying low-cost and easily applicable screening tools is essential. Objective: To investigate the discriminatory capacity of anthropometric indicators of obesity for screening hypertriglyceridemia in older adults. Methods: A population-based cross-sectional study was conducted with 223 community-dwelling older adults (57% women). Independent variables included body mass index (BMI), waist circumference (WC), abdominal circumference (AC), triceps skinfold thickness (TSF), body adiposity index (BAI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and conicity index (CI). Hypertriglyceridemia was defined as triglyceride levels ≥ 150 mg/dL. Discriminatory performance was assessed using receiver operating characteristic (ROC) curves, and associations were examined using Poisson regression with robust variance. Results: The prevalence of hypertriglyceridemia was 35%. Among older men, AC and CI showed the highest sensitivities (88.90% and 77.40%), while WHR and BMI demonstrated the highest specificities (83.10% and 76.90%). In older women, AC and BMI had the highest sensitivities (95.70% and 87.20%), whereas CI and WHtR exhibited the highest specificities (72.50% and 68.80%). All anthropometric indicators were positively associated with hypertriglyceridemia after adjustment for confounders. Conclusions: AC and CI demonstrated the strongest discriminatory capacity for screening older men with a higher probability of presenting hypertriglyceridemia, while AC and BMI showed the greatest discriminatory capacity among older women. In contrast, WHR and BMI had the highest ability to rule out the condition in older men, whereas CI and WHtR performed this role more effectively in older women. These findings show that low-cost anthropometric indicators can be used in a complementary manner, combining the most sensitive and the most specific measures to support an optimized triage process for hypertriglyceridemia in older adults, particularly in resource-limited settings. 2025-12-14 Obesities, Vol. 5, Pages 93: Anthropometric Indicators of Obesity as Screening Tools for Hypertriglyceridemia in Older Adults: A Cross-Sectional Study

Obesities doi: 10.3390/obesities5040093

Authors: Max Wolfgang Farias Paiva Caio Felipe de Sousa Miranda Gabriel Alves Godinho Carlos Daniel Dutra Lopes Tony Souza Queiroz Débora Jesus da Silva Sabrina da Silva Caires Paulo da Fonseca Valença Neto Claudio Bispo de Almeida Cezar Augusto Casotti Beatriz Cardoso Roriz Francisco Dimitre Rodrigo Pereira Santos Octavio Luiz Franco Danieli Fernanda Buccini Arthur Barros Fernandes Hellen Dayanny Ferreira Silva Pinheiro Lucas dos Santos

Background: Hypertriglyceridemia is a lipid disorder characterized by elevated plasma triglyceride levels, and its prevalence increases with aging. This condition contributes substantially to morbidity and mortality in older adults. In settings with limited access to laboratory testing, especially in developing countries such as Brazil, identifying low-cost and easily applicable screening tools is essential. Objective: To investigate the discriminatory capacity of anthropometric indicators of obesity for screening hypertriglyceridemia in older adults. Methods: A population-based cross-sectional study was conducted with 223 community-dwelling older adults (57% women). Independent variables included body mass index (BMI), waist circumference (WC), abdominal circumference (AC), triceps skinfold thickness (TSF), body adiposity index (BAI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and conicity index (CI). Hypertriglyceridemia was defined as triglyceride levels ≥ 150 mg/dL. Discriminatory performance was assessed using receiver operating characteristic (ROC) curves, and associations were examined using Poisson regression with robust variance. Results: The prevalence of hypertriglyceridemia was 35%. Among older men, AC and CI showed the highest sensitivities (88.90% and 77.40%), while WHR and BMI demonstrated the highest specificities (83.10% and 76.90%). In older women, AC and BMI had the highest sensitivities (95.70% and 87.20%), whereas CI and WHtR exhibited the highest specificities (72.50% and 68.80%). All anthropometric indicators were positively associated with hypertriglyceridemia after adjustment for confounders. Conclusions: AC and CI demonstrated the strongest discriminatory capacity for screening older men with a higher probability of presenting hypertriglyceridemia, while AC and BMI showed the greatest discriminatory capacity among older women. In contrast, WHR and BMI had the highest ability to rule out the condition in older men, whereas CI and WHtR performed this role more effectively in older women. These findings show that low-cost anthropometric indicators can be used in a complementary manner, combining the most sensitive and the most specific measures to support an optimized triage process for hypertriglyceridemia in older adults, particularly in resource-limited settings.

]]> Anthropometric Indicators of Obesity as Screening Tools for Hypertriglyceridemia in Older Adults: A Cross-Sectional Study Max Wolfgang Farias Paiva Caio Felipe de Sousa Miranda Gabriel Alves Godinho Carlos Daniel Dutra Lopes Tony Souza Queiroz Débora Jesus da Silva Sabrina da Silva Caires Paulo da Fonseca Valença Neto Claudio Bispo de Almeida Cezar Augusto Casotti Beatriz Cardoso Roriz Francisco Dimitre Rodrigo Pereira Santos Octavio Luiz Franco Danieli Fernanda Buccini Arthur Barros Fernandes Hellen Dayanny Ferreira Silva Pinheiro Lucas dos Santos doi: 10.3390/obesities5040093 Obesities 2025-12-14 Obesities 2025-12-14 5 4 Article 93 10.3390/obesities5040093 https://www.mdpi.com/2673-4168/5/4/93 Obesities, Vol. 5, Pages 92: Genetic and Epigenetic Modifiers of Ketogenic Diet Responses: Roles of Sex and Age https://www.mdpi.com/2673-4168/5/4/92 The ketogenic diet (KD) is a metabolic intervention characterized by high fat and very low carbohydrate intake, showing significant metabolic, neuroprotective, and therapeutic effects. However, its efficacy varies widely due to individual genetic and epigenetic factors. This review synthesizes current knowledge of genes most strongly associated with KD response, including polymorphisms in FTO, APOA2, PPAR, SCN1A, KCNQ2, STXBP1, CDKL5, the MODY gene group, and SLC2A1, which shape outcomes across lipid metabolism, energy expenditure, inflammation, and neurotransmission. Epigenomic modifications induced by a KD, such as changes in DNA methylation and histone acetylation involving BDNF, SLC12A5, KLF14, and others, modulate functional metabolic and neurological effects. Sex and age further modulate KD effects through distinct patterns of gene activation and hormonal interactions. These variables together impact metabolic and neurological outcomes and are critical for developing personalized nutrition and disease management strategies. Based on the reviewed evidence, genetic and epigenetic profiling can help identify patients who are likely to benefit from a KD (e.g., GLUT1DS, PDH deficiency) and those in whom a KD may be ineffective or harmful (e.g., SCOT or SLC2A1-independent defects). The review concludes that genetic and epigenetic profiling is recommended for personalized dietary interventions. 2025-12-10 Obesities, Vol. 5, Pages 92: Genetic and Epigenetic Modifiers of Ketogenic Diet Responses: Roles of Sex and Age

Obesities doi: 10.3390/obesities5040092

Authors: Marko Sablić Viktoria Čurila Senka Blažetić Marta Balog Marija Heffer Antonio Kokot Vedrana Ivić

The ketogenic diet (KD) is a metabolic intervention characterized by high fat and very low carbohydrate intake, showing significant metabolic, neuroprotective, and therapeutic effects. However, its efficacy varies widely due to individual genetic and epigenetic factors. This review synthesizes current knowledge of genes most strongly associated with KD response, including polymorphisms in FTO, APOA2, PPAR, SCN1A, KCNQ2, STXBP1, CDKL5, the MODY gene group, and SLC2A1, which shape outcomes across lipid metabolism, energy expenditure, inflammation, and neurotransmission. Epigenomic modifications induced by a KD, such as changes in DNA methylation and histone acetylation involving BDNF, SLC12A5, KLF14, and others, modulate functional metabolic and neurological effects. Sex and age further modulate KD effects through distinct patterns of gene activation and hormonal interactions. These variables together impact metabolic and neurological outcomes and are critical for developing personalized nutrition and disease management strategies. Based on the reviewed evidence, genetic and epigenetic profiling can help identify patients who are likely to benefit from a KD (e.g., GLUT1DS, PDH deficiency) and those in whom a KD may be ineffective or harmful (e.g., SCOT or SLC2A1-independent defects). The review concludes that genetic and epigenetic profiling is recommended for personalized dietary interventions.

]]> Genetic and Epigenetic Modifiers of Ketogenic Diet Responses: Roles of Sex and Age Marko Sablić Viktoria Čurila Senka Blažetić Marta Balog Marija Heffer Antonio Kokot Vedrana Ivić doi: 10.3390/obesities5040092 Obesities 2025-12-10 Obesities 2025-12-10 5 4 Review 92 10.3390/obesities5040092 https://www.mdpi.com/2673-4168/5/4/92 Obesities, Vol. 5, Pages 91: The Interplay of Diet, Lifestyle, and Metabolic Risk Among Saudi Adults with Metabolic Syndrome https://www.mdpi.com/2673-4168/5/4/91 Metabolic syndrome (MetS) is a multifactorial condition characterized by central obesity, hypertension, dyslipidaemia, and hyperglycaemia, predisposing individuals to cardiovascular disease and type 2 diabetes. This cross-sectional study investigated the relationship between dietary intake, sociodemographic factors, and components of MetS among Saudi adults aged 30 years and older attending King Abdulaziz University Hospital. Fifty-three participants meeting MetS diagnostic criteria were assessed through anthropometric measurements, biochemical markers, and two-day dietary recalls analyzed using MyFood24 software. Descriptive and correlation analyses were conducted using SPSS 26.0. The majority of participants (73.6%) were aged over 50 years, were obese (75.5%), and exhibited a high waist circumference (94.3%). Low fibre (6.6 g/day) and high fat (41.8 g/day) intake patterns were evident. Salt intake showed a significant inverse correlation with systolic blood pressure (ρ = −0.36, p < 0.01), potentially reflecting under-reporting or dietary adjustments following diagnosis. Higher BMI correlated positively with waist circumference and diastolic pressure, while frequent physical activity correlated negatively with these parameters. These findings emphasize the influence of diet and lifestyle on metabolic risk and underscore the need for culturally tailored interventions promoting balanced macronutrient intake, increased fibre consumption, and enhanced physical activity to mitigate MetS prevalence among Saudi adults. 2025-12-08 Obesities, Vol. 5, Pages 91: The Interplay of Diet, Lifestyle, and Metabolic Risk Among Saudi Adults with Metabolic Syndrome

Obesities doi: 10.3390/obesities5040091

Authors: Maryam S. Hafiz Wala I. Alzahrani Sarah N. Alsharif Doaa A. Alyoubi Amal M. Alrizqi Hanan Alwassam

Metabolic syndrome (MetS) is a multifactorial condition characterized by central obesity, hypertension, dyslipidaemia, and hyperglycaemia, predisposing individuals to cardiovascular disease and type 2 diabetes. This cross-sectional study investigated the relationship between dietary intake, sociodemographic factors, and components of MetS among Saudi adults aged 30 years and older attending King Abdulaziz University Hospital. Fifty-three participants meeting MetS diagnostic criteria were assessed through anthropometric measurements, biochemical markers, and two-day dietary recalls analyzed using MyFood24 software. Descriptive and correlation analyses were conducted using SPSS 26.0. The majority of participants (73.6%) were aged over 50 years, were obese (75.5%), and exhibited a high waist circumference (94.3%). Low fibre (6.6 g/day) and high fat (41.8 g/day) intake patterns were evident. Salt intake showed a significant inverse correlation with systolic blood pressure (ρ = −0.36, p < 0.01), potentially reflecting under-reporting or dietary adjustments following diagnosis. Higher BMI correlated positively with waist circumference and diastolic pressure, while frequent physical activity correlated negatively with these parameters. These findings emphasize the influence of diet and lifestyle on metabolic risk and underscore the need for culturally tailored interventions promoting balanced macronutrient intake, increased fibre consumption, and enhanced physical activity to mitigate MetS prevalence among Saudi adults.

]]> The Interplay of Diet, Lifestyle, and Metabolic Risk Among Saudi Adults with Metabolic Syndrome Maryam S. Hafiz Wala I. Alzahrani Sarah N. Alsharif Doaa A. Alyoubi Amal M. Alrizqi Hanan Alwassam doi: 10.3390/obesities5040091 Obesities 2025-12-08 Obesities 2025-12-08 5 4 Article 91 10.3390/obesities5040091 https://www.mdpi.com/2673-4168/5/4/91 Obesities, Vol. 5, Pages 90: Evaluating Dose Titration in Semaglutide and Tirzepatide for Weight Loss: A Retrospective Academic Call Center Study https://www.mdpi.com/2673-4168/5/4/90 Obesity affects approximately 40% of U.S. adults and is associated with increased cardiometabolic risk. While lifestyle interventions remain fundamental, pharmacologic therapies such as Semaglutide and tirzepatide have demonstrated significant weight reduction in clinical trials when titrated to maintenance doses. However, real-world adherence to recommended titration schedules remains unclear. This retrospective observational study evaluated adults prescribed Semaglutide (Wegovy®) or Tirzepatide (Zepbound®) for weight management between January 2021 and April 2025 through ICUBAcares, a pharmacist-led call center. Primary outcomes included the proportion of patients reaching the recommended maintenance dose and time required to do so. Secondary outcomes examined prescriber specialty patterns and monthly plan costs for non-optimized dosing. Among 739 medication courses, 52.9% of Semaglutide users reached the 2.4 mg dose versus 77.6% of tirzepatide users reaching 15 mg (p < 0.001). Median time to maintenance was significantly shorter for tirzepatide (32 days) than Semaglutide (143 days) (p < 0.001). Endocrinologists had the highest success rate for Tirzepatide (88.2%), while family medicine had the highest volume for both. Non-optimized dosing was associated with higher estimated monthly plan costs. These findings underscore the importance of improving adherence to titration protocols in real-world settings to maximize both clinical and economic outcomes in obesity pharmacotherapy. 2025-12-05 Obesities, Vol. 5, Pages 90: Evaluating Dose Titration in Semaglutide and Tirzepatide for Weight Loss: A Retrospective Academic Call Center Study

Obesities doi: 10.3390/obesities5040090

Authors: Goar Alvarez Lianette Veliz Stephanie Michaels David Pino Jun Wu

Obesity affects approximately 40% of U.S. adults and is associated with increased cardiometabolic risk. While lifestyle interventions remain fundamental, pharmacologic therapies such as Semaglutide and tirzepatide have demonstrated significant weight reduction in clinical trials when titrated to maintenance doses. However, real-world adherence to recommended titration schedules remains unclear. This retrospective observational study evaluated adults prescribed Semaglutide (Wegovy®) or Tirzepatide (Zepbound®) for weight management between January 2021 and April 2025 through ICUBAcares, a pharmacist-led call center. Primary outcomes included the proportion of patients reaching the recommended maintenance dose and time required to do so. Secondary outcomes examined prescriber specialty patterns and monthly plan costs for non-optimized dosing. Among 739 medication courses, 52.9% of Semaglutide users reached the 2.4 mg dose versus 77.6% of tirzepatide users reaching 15 mg (p < 0.001). Median time to maintenance was significantly shorter for tirzepatide (32 days) than Semaglutide (143 days) (p < 0.001). Endocrinologists had the highest success rate for Tirzepatide (88.2%), while family medicine had the highest volume for both. Non-optimized dosing was associated with higher estimated monthly plan costs. These findings underscore the importance of improving adherence to titration protocols in real-world settings to maximize both clinical and economic outcomes in obesity pharmacotherapy.

]]> Evaluating Dose Titration in Semaglutide and Tirzepatide for Weight Loss: A Retrospective Academic Call Center Study Goar Alvarez Lianette Veliz Stephanie Michaels David Pino Jun Wu doi: 10.3390/obesities5040090 Obesities 2025-12-05 Obesities 2025-12-05 5 4 Article 90 10.3390/obesities5040090 https://www.mdpi.com/2673-4168/5/4/90 Obesities, Vol. 5, Pages 89: Trends in Anthropometric and Cardiometabolic Risk Factor Changes Among Health Professionals: A 3-Year Follow-Up Study in Taiwan https://www.mdpi.com/2673-4168/5/4/89 Objectives: The purpose of this study is to evaluate the trend of anthropometric and cardiometabolic risk (CMRs) changes among health professionals over a three-year period at a medical center in Taiwan. Study Design: A 3-year follow-up cohort study design. Methods: This cohort study was conducted from 2019 to 2022 in a single healthcare center. The participants underwent annual physical check-ups for three consecutive years. CMRs were measured using standard methods and weight status change was measured using BMI. We used McNemar test and Wilcoxon Sign Rank test to evaluate the differences within and between subgroups. We used logistic regression to examine the risk of increased CMRs among subgroups of different weight status changes. Results: A total of 2217 participants (1641 females and 576 males) were included in this study, with a mean age of 40.2 ± 10.2 years. During this period, 72 (4.4%) female participants’ weight status changed from normal weight to overweight or obese and 530 (32.3%) remained overweight or obese. Among males, the proportion was 6.8% and 61.1%, respectively (p < 0.01). Participants who remained overweight or obese have more adverse CMRs. Compared to remained normal weight male subjects, the mean systolic blood pressure (131.0 ± 18.1 mmHg) and fasting blood glucose (94.4 ± 13.5 mg/dL) were higher in remained overweight or obese subjects (p < 0.001). Among females, those who remained overweight or obese have 4.01 (95% CI 2.92–5.51) times higher risk for abnormal diastolic blood pressure and 2.98 (95% CI 2.05–4.32) times higher risk for abnormal blood glucose compared to those with remained normal weight. Conclusions: Participants who remained overweight or became obese had more adverse CMRs such as high blood pressure, hyperglycemia, and dyslipidemia during the 3-year follow-up period. 2025-12-04 Obesities, Vol. 5, Pages 89: Trends in Anthropometric and Cardiometabolic Risk Factor Changes Among Health Professionals: A 3-Year Follow-Up Study in Taiwan

Obesities doi: 10.3390/obesities5040089

Authors: Yi-Ru Chen Nain-Feng Chu Der-Min Wu Wen-Chuan Shen

Objectives: The purpose of this study is to evaluate the trend of anthropometric and cardiometabolic risk (CMRs) changes among health professionals over a three-year period at a medical center in Taiwan. Study Design: A 3-year follow-up cohort study design. Methods: This cohort study was conducted from 2019 to 2022 in a single healthcare center. The participants underwent annual physical check-ups for three consecutive years. CMRs were measured using standard methods and weight status change was measured using BMI. We used McNemar test and Wilcoxon Sign Rank test to evaluate the differences within and between subgroups. We used logistic regression to examine the risk of increased CMRs among subgroups of different weight status changes. Results: A total of 2217 participants (1641 females and 576 males) were included in this study, with a mean age of 40.2 ± 10.2 years. During this period, 72 (4.4%) female participants’ weight status changed from normal weight to overweight or obese and 530 (32.3%) remained overweight or obese. Among males, the proportion was 6.8% and 61.1%, respectively (p < 0.01). Participants who remained overweight or obese have more adverse CMRs. Compared to remained normal weight male subjects, the mean systolic blood pressure (131.0 ± 18.1 mmHg) and fasting blood glucose (94.4 ± 13.5 mg/dL) were higher in remained overweight or obese subjects (p < 0.001). Among females, those who remained overweight or obese have 4.01 (95% CI 2.92–5.51) times higher risk for abnormal diastolic blood pressure and 2.98 (95% CI 2.05–4.32) times higher risk for abnormal blood glucose compared to those with remained normal weight. Conclusions: Participants who remained overweight or became obese had more adverse CMRs such as high blood pressure, hyperglycemia, and dyslipidemia during the 3-year follow-up period.

]]> Trends in Anthropometric and Cardiometabolic Risk Factor Changes Among Health Professionals: A 3-Year Follow-Up Study in Taiwan Yi-Ru Chen Nain-Feng Chu Der-Min Wu Wen-Chuan Shen doi: 10.3390/obesities5040089 Obesities 2025-12-04 Obesities 2025-12-04 5 4 Article 89 10.3390/obesities5040089 https://www.mdpi.com/2673-4168/5/4/89 Obesities, Vol. 5, Pages 88: Nutritional Approaches to Enhance GLP-1 Analogue Therapy in Obesity: A Narrative Review https://www.mdpi.com/2673-4168/5/4/88 Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are highly effective in the management of obesity; however, their efficacy and tolerability may be further optimized through complementary nutritional strategies. Such interventions may address key challenges associated with GLP-1RA therapy, including gastrointestinal adverse effects, lean mass loss, and reduced long-term adherence leading to weight regain. Evidence from preclinical and clinical studies indicates that omega-3 polyunsaturated fatty acids may enhance the metabolic benefits of GLP-1RAs and attenuate lean mass loss, primarily via anti-inflammatory pathways and modulation of protein synthesis. Synergistic effects have also been reported with other bioactive compounds—such as flavonoids and anthocyanins, which improve metabolic outcomes; probiotics and prebiotics, which may alleviate gastrointestinal intolerance; and high-quality protein sources, which support body composition preservation. Collectively, these findings suggest that nutritional adjuncts may complement GLP-1RA therapies through convergent physiological mechanisms, including the regulation of inflammation, gut microbiome composition, and cellular metabolism. While current data highlight the promise of integrated pharmaco-nutritional strategies as adjuncts to GLP-1-based obesity therapy, further randomized controlled trials are needed to establish the most effective interventions and protocols. 2025-12-02 Obesities, Vol. 5, Pages 88: Nutritional Approaches to Enhance GLP-1 Analogue Therapy in Obesity: A Narrative Review

Obesities doi: 10.3390/obesities5040088

Authors: Denise Deo Dias Andrea Rodrigues Vasconcelos Ana Carolina Remondi Souza Caroline de Menezes Isabella Sobral Teixeira e Silva José João Name

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are highly effective in the management of obesity; however, their efficacy and tolerability may be further optimized through complementary nutritional strategies. Such interventions may address key challenges associated with GLP-1RA therapy, including gastrointestinal adverse effects, lean mass loss, and reduced long-term adherence leading to weight regain. Evidence from preclinical and clinical studies indicates that omega-3 polyunsaturated fatty acids may enhance the metabolic benefits of GLP-1RAs and attenuate lean mass loss, primarily via anti-inflammatory pathways and modulation of protein synthesis. Synergistic effects have also been reported with other bioactive compounds—such as flavonoids and anthocyanins, which improve metabolic outcomes; probiotics and prebiotics, which may alleviate gastrointestinal intolerance; and high-quality protein sources, which support body composition preservation. Collectively, these findings suggest that nutritional adjuncts may complement GLP-1RA therapies through convergent physiological mechanisms, including the regulation of inflammation, gut microbiome composition, and cellular metabolism. While current data highlight the promise of integrated pharmaco-nutritional strategies as adjuncts to GLP-1-based obesity therapy, further randomized controlled trials are needed to establish the most effective interventions and protocols.

]]> Nutritional Approaches to Enhance GLP-1 Analogue Therapy in Obesity: A Narrative Review Denise Deo Dias Andrea Rodrigues Vasconcelos Ana Carolina Remondi Souza Caroline de Menezes Isabella Sobral Teixeira e Silva José João Name doi: 10.3390/obesities5040088 Obesities 2025-12-02 Obesities 2025-12-02 5 4 Review 88 10.3390/obesities5040088 https://www.mdpi.com/2673-4168/5/4/88 Obesities, Vol. 5, Pages 87: Cardiovascular Risk Assessment Across Different Obesity Phenotypes https://www.mdpi.com/2673-4168/5/4/87 Background/Objectives: Obesity is a major risk factor for cardiovascular disease (CVD), but traditional risk calculators such as Systematic COronary Risk Evaluation (SCORE2) may not fully capture the elevated risks in individuals with obesity, especially when metabolic health is considered. This study aimed to evaluate the effectiveness of QRESEARCH risk estimator version 3 (QRISK3) in estimating 10-year cardiovascular risk in individuals with varying obesity phenotypes compared to SCORE2. Methods: A total of 88 participants (25 men, 63 women; mean age 37.4 ± 11.8 years) were categorized into four obesity phenotypes according to metabolic and anthropometric criteria. The 10-year CVD risk was calculated using SCORE2 and QRISK3 algorithms. Functional cardiovascular assessment included blood pressure (BP) measurement and electrocardiogram (ECG) interpretation for conduction abnormalities and left ventricular hypertrophy (LVH). Biochemical analysis included carbohydrate metabolism (fasting glucose, postprandial glucose, HbA1c) and lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides, atherogenic index). Results: SCORE2 underestimated CVD risk (3–8%), whereas QRISK3 predicted higher values (6–16%), particularly in metabolically unhealthy phenotypes. LVH occurred in 26–45% of participants, with elevated BP and early subclinical ECG changes even in metabolically healthy obesity individuals. Carbohydrate metabolism disturbances were observed in metabolically unhealthy participants with normal or elevated BMI, while lipid abnormalities—including elevated total cholesterol, LDL-C, triglycerides, and atherogenic index—were prominent in these metabolically unhealthy phenotypes. Insulin resistance, assessed via the triglyceride–glucose index, exceeded reference ranges in all obesity phenotypes, with the highest values seen in metabolically unhealthy individuals. Conclusions: QRISK3 provides a more precise and thorough assessment of 10-year cardiovascular risk in individuals with obesity than SCORE2. These findings highlight the importance of incorporating anthropometric and metabolic data into cardiovascular risk assessments and support the clinical use of QRISK3 for more personalized risk stratification, especially in populations with obesity and metabolic disturbances. Early identification of high-risk individuals using QRISK3 could lead to more timely and targeted preventive interventions, improving long-term cardiovascular outcomes. 2025-12-02 Obesities, Vol. 5, Pages 87: Cardiovascular Risk Assessment Across Different Obesity Phenotypes

Obesities doi: 10.3390/obesities5040087

Authors: Sergii Vernygorodskyi Tetiana Sekret Anton B. Tonchev Kameliya Zhechkova Bratoeva Viktor Vernihorodskii

Background/Objectives: Obesity is a major risk factor for cardiovascular disease (CVD), but traditional risk calculators such as Systematic COronary Risk Evaluation (SCORE2) may not fully capture the elevated risks in individuals with obesity, especially when metabolic health is considered. This study aimed to evaluate the effectiveness of QRESEARCH risk estimator version 3 (QRISK3) in estimating 10-year cardiovascular risk in individuals with varying obesity phenotypes compared to SCORE2. Methods: A total of 88 participants (25 men, 63 women; mean age 37.4 ± 11.8 years) were categorized into four obesity phenotypes according to metabolic and anthropometric criteria. The 10-year CVD risk was calculated using SCORE2 and QRISK3 algorithms. Functional cardiovascular assessment included blood pressure (BP) measurement and electrocardiogram (ECG) interpretation for conduction abnormalities and left ventricular hypertrophy (LVH). Biochemical analysis included carbohydrate metabolism (fasting glucose, postprandial glucose, HbA1c) and lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides, atherogenic index). Results: SCORE2 underestimated CVD risk (3–8%), whereas QRISK3 predicted higher values (6–16%), particularly in metabolically unhealthy phenotypes. LVH occurred in 26–45% of participants, with elevated BP and early subclinical ECG changes even in metabolically healthy obesity individuals. Carbohydrate metabolism disturbances were observed in metabolically unhealthy participants with normal or elevated BMI, while lipid abnormalities—including elevated total cholesterol, LDL-C, triglycerides, and atherogenic index—were prominent in these metabolically unhealthy phenotypes. Insulin resistance, assessed via the triglyceride–glucose index, exceeded reference ranges in all obesity phenotypes, with the highest values seen in metabolically unhealthy individuals. Conclusions: QRISK3 provides a more precise and thorough assessment of 10-year cardiovascular risk in individuals with obesity than SCORE2. These findings highlight the importance of incorporating anthropometric and metabolic data into cardiovascular risk assessments and support the clinical use of QRISK3 for more personalized risk stratification, especially in populations with obesity and metabolic disturbances. Early identification of high-risk individuals using QRISK3 could lead to more timely and targeted preventive interventions, improving long-term cardiovascular outcomes.

]]> Cardiovascular Risk Assessment Across Different Obesity Phenotypes Sergii Vernygorodskyi Tetiana Sekret Anton B. Tonchev Kameliya Zhechkova Bratoeva Viktor Vernihorodskii doi: 10.3390/obesities5040087 Obesities 2025-12-02 Obesities 2025-12-02 5 4 Article 87 10.3390/obesities5040087 https://www.mdpi.com/2673-4168/5/4/87 Obesities, Vol. 5, Pages 86: Obesity: Genetic Insights, Therapeutic Strategies, Pharmacoeconomic Impact, and Psychosocial Dimensions https://www.mdpi.com/2673-4168/5/4/86 Obesity has emerged as one of the most complex and urgent public health challenges of the twenty-first century, driven by genetic, environmental, metabolic, and psychosocial determinants that collectively disturb energy homeostasis and systemic health. It is characterized by adipose tissue dysfunction, insulin resistance, chronic low-grade inflammation, and gut microbiota dysbiosis, all of which interact to perpetuate metabolic and cardiovascular diseases. Beyond the biological dimension, obesity profoundly affects mental health, being closely linked to depression, anxiety, body-image dissatisfaction, and stigma, which further reduce adherence to treatment. Current therapeutic strategies rely on a stepped-care approach, beginning with lifestyle interventions encompassing dietary modification, physical activity, and behavioral therapy. Pharmacologic treatments, particularly incretin-based agents such as semaglutide, liraglutide, and tirzepatide have transformed medical management through substantial and sustained weight loss, while bariatric surgery remains the most effective long-term option for severe obesity. Emerging approaches, including gene therapy, microbiome modulation, and nanomedicine, offer mechanistically targeted and potentially safer alternatives, though they remain largely experimental. Pharmacoeconomic analyses support the cost-effectiveness of combining behavioral, pharmacological, and surgical modalities, highlighting the economic advantage of integrated care models. Meanwhile, artificial intelligence and machine learning are redefining obesity research and management, enhancing cancer risk prediction, personalizing pharmacotherapy, optimizing resource allocation, and enabling precision medicine through multi-omics and imaging integration. Collectively, these insights support a shift toward a learning health-system paradigm that unites mechanistically anchored therapies with digital and AI-driven personalization to achieve sustainable weight reduction, reduce cardiometabolic and cancer burden, and improve global health outcomes. 2025-11-28 Obesities, Vol. 5, Pages 86: Obesity: Genetic Insights, Therapeutic Strategies, Pharmacoeconomic Impact, and Psychosocial Dimensions

Obesities doi: 10.3390/obesities5040086

Authors: Gladious Naguib El-hadidy Youssef Basem Mahmoud M. Mokhtar Salma A. Hamed Sara M. Abdelstar Abdelrhman R. Nasef Rehab Abdelmonem

Obesity has emerged as one of the most complex and urgent public health challenges of the twenty-first century, driven by genetic, environmental, metabolic, and psychosocial determinants that collectively disturb energy homeostasis and systemic health. It is characterized by adipose tissue dysfunction, insulin resistance, chronic low-grade inflammation, and gut microbiota dysbiosis, all of which interact to perpetuate metabolic and cardiovascular diseases. Beyond the biological dimension, obesity profoundly affects mental health, being closely linked to depression, anxiety, body-image dissatisfaction, and stigma, which further reduce adherence to treatment. Current therapeutic strategies rely on a stepped-care approach, beginning with lifestyle interventions encompassing dietary modification, physical activity, and behavioral therapy. Pharmacologic treatments, particularly incretin-based agents such as semaglutide, liraglutide, and tirzepatide have transformed medical management through substantial and sustained weight loss, while bariatric surgery remains the most effective long-term option for severe obesity. Emerging approaches, including gene therapy, microbiome modulation, and nanomedicine, offer mechanistically targeted and potentially safer alternatives, though they remain largely experimental. Pharmacoeconomic analyses support the cost-effectiveness of combining behavioral, pharmacological, and surgical modalities, highlighting the economic advantage of integrated care models. Meanwhile, artificial intelligence and machine learning are redefining obesity research and management, enhancing cancer risk prediction, personalizing pharmacotherapy, optimizing resource allocation, and enabling precision medicine through multi-omics and imaging integration. Collectively, these insights support a shift toward a learning health-system paradigm that unites mechanistically anchored therapies with digital and AI-driven personalization to achieve sustainable weight reduction, reduce cardiometabolic and cancer burden, and improve global health outcomes.

]]> Obesity: Genetic Insights, Therapeutic Strategies, Pharmacoeconomic Impact, and Psychosocial Dimensions Gladious Naguib El-hadidy Youssef Basem Mahmoud M. Mokhtar Salma A. Hamed Sara M. Abdelstar Abdelrhman R. Nasef Rehab Abdelmonem doi: 10.3390/obesities5040086 Obesities 2025-11-28 Obesities 2025-11-28 5 4 Review 86 10.3390/obesities5040086 https://www.mdpi.com/2673-4168/5/4/86 Obesities, Vol. 5, Pages 85: Time Since Bariatric and Metabolic Surgery Is Associated with Ultra-Processed Food Intake and Food Addiction but Not with Culinary Abilities in Adults https://www.mdpi.com/2673-4168/5/4/85 To evaluate the consumption of ultra-processed foods (UPFs), culinary abilities, and food addiction (FA) in adults after different periods since bariatric and metabolic surgery, this cross-sectional study recruited and collected data via social media from adults who underwent metabolic and bariatric surgery. The Brazil Food and Nutritional Surveillance System markers of dietary consumption and the NOVA-UPF screener assessed dietary patterns and UPF consumption, the modified Yale Food Addiction Scale 2.0 assessed FA, and the Cooking Skills Index (CSI) assessed culinary abilities. 1525 participants were included, with a mean age of 38 ± 8 years and a mean time since surgery of 37 ± 54 months. Individuals with longer postoperative time showed a higher NOVA-UPF score and higher consumption of hamburgers/sausages, sweetened beverages, and instant noodles (p < 0.01 for all), without a corresponding decrease in fresh fruit and vegetable consumption. Each year since surgery increased NOVA-UPF score by 0.67 [CI95%: 0.57; 0.76] points. CSI showed no association with time (−0.41; [CI95%: −1.33; 0.50]), while FA prevalence was lowest at 48 months and increased thereafter (p < 0.01). FA prevalence initially decreased up to 4 years post-surgery, followed by a partial increase beyond 4 years, although remaining below levels observed within the first 6 months. Time since surgery is associated with higher UPF consumption and a non-linear trajectory of FA prevalence, but not with culinary abilities. 2025-11-28 Obesities, Vol. 5, Pages 85: Time Since Bariatric and Metabolic Surgery Is Associated with Ultra-Processed Food Intake and Food Addiction but Not with Culinary Abilities in Adults

Obesities doi: 10.3390/obesities5040085

Authors: André Eduardo da Silva-Júnior Natália Gomes da Silva Lopes Jennifer Mikaella Ferreira Melo Maria Clara Tavares Farias da Silva Mateus de Lima Macena Nassib Bezerra Bueno

To evaluate the consumption of ultra-processed foods (UPFs), culinary abilities, and food addiction (FA) in adults after different periods since bariatric and metabolic surgery, this cross-sectional study recruited and collected data via social media from adults who underwent metabolic and bariatric surgery. The Brazil Food and Nutritional Surveillance System markers of dietary consumption and the NOVA-UPF screener assessed dietary patterns and UPF consumption, the modified Yale Food Addiction Scale 2.0 assessed FA, and the Cooking Skills Index (CSI) assessed culinary abilities. 1525 participants were included, with a mean age of 38 ± 8 years and a mean time since surgery of 37 ± 54 months. Individuals with longer postoperative time showed a higher NOVA-UPF score and higher consumption of hamburgers/sausages, sweetened beverages, and instant noodles (p < 0.01 for all), without a corresponding decrease in fresh fruit and vegetable consumption. Each year since surgery increased NOVA-UPF score by 0.67 [CI95%: 0.57; 0.76] points. CSI showed no association with time (−0.41; [CI95%: −1.33; 0.50]), while FA prevalence was lowest at 48 months and increased thereafter (p < 0.01). FA prevalence initially decreased up to 4 years post-surgery, followed by a partial increase beyond 4 years, although remaining below levels observed within the first 6 months. Time since surgery is associated with higher UPF consumption and a non-linear trajectory of FA prevalence, but not with culinary abilities.

]]> Time Since Bariatric and Metabolic Surgery Is Associated with Ultra-Processed Food Intake and Food Addiction but Not with Culinary Abilities in Adults André Eduardo da Silva-Júnior Natália Gomes da Silva Lopes Jennifer Mikaella Ferreira Melo Maria Clara Tavares Farias da Silva Mateus de Lima Macena Nassib Bezerra Bueno doi: 10.3390/obesities5040085 Obesities 2025-11-28 Obesities 2025-11-28 5 4 Article 85 10.3390/obesities5040085 https://www.mdpi.com/2673-4168/5/4/85 Obesities, Vol. 5, Pages 84: How Can Lockdown Influence Eating Habits? The Spanish Case During the COVID Pandemic https://www.mdpi.com/2673-4168/5/4/84 Background and Objectives: Previous research shows that stress can alter eating habits. This study analyzed the impact of COVID-19 confinement on eating behaviors and weight in Spanish adults, as well as related factors. Methods: A total of 2834 adults (69.3% women, Mean age: 41.36) completed an online questionnaire assessing eating habits, weight, and sociodemographic variables. Results: Strict lockdown in Spain was linked to a general worsening of eating habits, particularly increased food intake and weight gain. Risk factors for less healthy eating and weight gain included being female (p < 0.001), under 35 years old (p < 0.001), overweight or obese (p < 0.001), caring for minors (p = 0.002), and experiencing nervousness or anxiety (p < 0.001). Conversely, maintaining pre-confinement eating habits and weight was more common among men (p < 0.001), individuals aged 50 years or older (p < 0.001), those with normal or underweight BMI (p < 0.001), those working outside the home (p < 0.013), and those without minors in their care (p = 0.001). Conclusions: Prolonged lockdowns associated with high stress may negatively influence diet and weight. Prevention strategies should therefore promote healthy eating during such periods, particularly targeting groups at higher risk of worsening habits and weight gain. 2025-11-27 Obesities, Vol. 5, Pages 84: How Can Lockdown Influence Eating Habits? The Spanish Case During the COVID Pandemic

Obesities doi: 10.3390/obesities5040084

Authors: José I. Baile María J. González-Calderón María F. Rabito-Alcón Eva Izquierdo-Sotorrío

Background and Objectives: Previous research shows that stress can alter eating habits. This study analyzed the impact of COVID-19 confinement on eating behaviors and weight in Spanish adults, as well as related factors. Methods: A total of 2834 adults (69.3% women, Mean age: 41.36) completed an online questionnaire assessing eating habits, weight, and sociodemographic variables. Results: Strict lockdown in Spain was linked to a general worsening of eating habits, particularly increased food intake and weight gain. Risk factors for less healthy eating and weight gain included being female (p < 0.001), under 35 years old (p < 0.001), overweight or obese (p < 0.001), caring for minors (p = 0.002), and experiencing nervousness or anxiety (p < 0.001). Conversely, maintaining pre-confinement eating habits and weight was more common among men (p < 0.001), individuals aged 50 years or older (p < 0.001), those with normal or underweight BMI (p < 0.001), those working outside the home (p < 0.013), and those without minors in their care (p = 0.001). Conclusions: Prolonged lockdowns associated with high stress may negatively influence diet and weight. Prevention strategies should therefore promote healthy eating during such periods, particularly targeting groups at higher risk of worsening habits and weight gain.

]]> How Can Lockdown Influence Eating Habits? The Spanish Case During the COVID Pandemic José I. Baile María J. González-Calderón María F. Rabito-Alcón Eva Izquierdo-Sotorrío doi: 10.3390/obesities5040084 Obesities 2025-11-27 Obesities 2025-11-27 5 4 Article 84 10.3390/obesities5040084 https://www.mdpi.com/2673-4168/5/4/84 Obesities, Vol. 5, Pages 83: Effects of Obesity Treatment Type on Emotional Eating and Weight/Waist Circumference Changes in Women Through Interrelations of Induced Self-Regulation and Self-Efficacy https://www.mdpi.com/2673-4168/5/4/83 Obesity is a medical issue of increasing prevalence, with emotional eating being a key contributor to the problem, particularly in women. Theory and previous research suggest that obesity treatment participants’ self-regulatory abilities and self-efficacy to control eating are viable targets for improving emotional eating and related impacts on an unhealthy body composition. However, an improved understanding of interrelations between self-regulatory and self-efficacy changes are needed to inform behavioral treatments, which have had mostly negligible effects beyond the short term. Women were randomized into 6-month community-based obesity treatment conditions of (a) cognitive–behavioral methods with attention on emotional eating (n = 48), (b) cognitive–behavioral methods with no specific attention on emotional eating (n = 48), and (c) weight loss education (n = 50). Study-related improvements were greater in the merged cognitive–behavioral condition (n = 96; aggregated because the two corresponding treatment conditions demonstrated no significant differences). Using data aggregated across all study participants, early change in eating-related self-regulation was a significantly stronger predictor of longer-term change in eating-related self-efficacy than vice versa. Consistent with that finding, paths from treatment condition→change in self-regulation→change in self-efficacy→change in emotional eating over both 6 and 12 months were significant but not where change in self-efficacy was, instead, entered as a predictor of self-regulation change. Lessened emotional eating was significantly associated with concurrent reductions in weight and waist circumference. Consistent with self-regulation theory, findings suggest benefits for cognitive–behavioral obesity treatments over the more common education-based approaches, as well as benefits for first focusing on self-regulation that could empower increases in self-efficacy. Consistent with self-efficacy theory, such induced increases might promote favorable behavioral changes. 2025-11-22 Obesities, Vol. 5, Pages 83: Effects of Obesity Treatment Type on Emotional Eating and Weight/Waist Circumference Changes in Women Through Interrelations of Induced Self-Regulation and Self-Efficacy

Obesities doi: 10.3390/obesities5040083

Authors: James J. Annesi Steven B. Machek

Obesity is a medical issue of increasing prevalence, with emotional eating being a key contributor to the problem, particularly in women. Theory and previous research suggest that obesity treatment participants’ self-regulatory abilities and self-efficacy to control eating are viable targets for improving emotional eating and related impacts on an unhealthy body composition. However, an improved understanding of interrelations between self-regulatory and self-efficacy changes are needed to inform behavioral treatments, which have had mostly negligible effects beyond the short term. Women were randomized into 6-month community-based obesity treatment conditions of (a) cognitive–behavioral methods with attention on emotional eating (n = 48), (b) cognitive–behavioral methods with no specific attention on emotional eating (n = 48), and (c) weight loss education (n = 50). Study-related improvements were greater in the merged cognitive–behavioral condition (n = 96; aggregated because the two corresponding treatment conditions demonstrated no significant differences). Using data aggregated across all study participants, early change in eating-related self-regulation was a significantly stronger predictor of longer-term change in eating-related self-efficacy than vice versa. Consistent with that finding, paths from treatment condition→change in self-regulation→change in self-efficacy→change in emotional eating over both 6 and 12 months were significant but not where change in self-efficacy was, instead, entered as a predictor of self-regulation change. Lessened emotional eating was significantly associated with concurrent reductions in weight and waist circumference. Consistent with self-regulation theory, findings suggest benefits for cognitive–behavioral obesity treatments over the more common education-based approaches, as well as benefits for first focusing on self-regulation that could empower increases in self-efficacy. Consistent with self-efficacy theory, such induced increases might promote favorable behavioral changes.

]]> Effects of Obesity Treatment Type on Emotional Eating and Weight/Waist Circumference Changes in Women Through Interrelations of Induced Self-Regulation and Self-Efficacy James J. Annesi Steven B. Machek doi: 10.3390/obesities5040083 Obesities 2025-11-22 Obesities 2025-11-22 5 4 Article 83 10.3390/obesities5040083 https://www.mdpi.com/2673-4168/5/4/83 Obesities, Vol. 5, Pages 82: Effect of D-β-Hydroxybutyric Acid on Body Fat in Japanese Adults: A Randomized, Double-Blind, Placebo-Controlled Study https://www.mdpi.com/2673-4168/5/4/82 Ketone metabolism is currently being spotlighted for its health benefits. Strict dietary carbohydrate restriction is required to increase plasma ketone levels, which can be achieved with D-β-hydroxybutyric acid (D-BHB) supplementation as well. Although 2.9 g/day of D-BHB may reduce body fat without dieting or exercise interventions, the lower effective intake limit of exogenous D-BHB remains unknown. In this randomized, double-blind, placebo-controlled study (UMIN000054231), we aimed to assess the safety and fat-reduction effects of a 12-week intake of D-BHB in healthy Japanese adults (low-dose [1.5 g/day, n = 33], normal-dose [2.9 g/day, n = 33], and placebo [n = 34] groups). Blood samples were collected pre- and post-intervention. Participants’ blood chemistry, anthropometric, and body composition parameters were investigated. The low-dose group had a lower visceral fat area and body mass index (BMI) and higher plasma ketone levels than the placebo group. The normal-dose group had a significantly lower visceral fat area than the placebo group. Significant between-group (normal-dose vs. placebo) differences were observed in body weight, BMI, body fat percentage, fat mass, and plasma ketone levels. Participants reported no D-BHB-related adverse effects or discomfort. In conclusion, 1.5 or 2.9 g/day of D-BHB may reduce body fat without dieting or exercise interventions. 2025-11-14 Obesities, Vol. 5, Pages 82: Effect of D-β-Hydroxybutyric Acid on Body Fat in Japanese Adults: A Randomized, Double-Blind, Placebo-Controlled Study

Obesities doi: 10.3390/obesities5040082

Authors: Shohei Katsuya Yoshikazu Kawata Jun Kawamura Tsuyoshi Goto Tsuyoshi Takara Jun Tsubota

Ketone metabolism is currently being spotlighted for its health benefits. Strict dietary carbohydrate restriction is required to increase plasma ketone levels, which can be achieved with D-β-hydroxybutyric acid (D-BHB) supplementation as well. Although 2.9 g/day of D-BHB may reduce body fat without dieting or exercise interventions, the lower effective intake limit of exogenous D-BHB remains unknown. In this randomized, double-blind, placebo-controlled study (UMIN000054231), we aimed to assess the safety and fat-reduction effects of a 12-week intake of D-BHB in healthy Japanese adults (low-dose [1.5 g/day, n = 33], normal-dose [2.9 g/day, n = 33], and placebo [n = 34] groups). Blood samples were collected pre- and post-intervention. Participants’ blood chemistry, anthropometric, and body composition parameters were investigated. The low-dose group had a lower visceral fat area and body mass index (BMI) and higher plasma ketone levels than the placebo group. The normal-dose group had a significantly lower visceral fat area than the placebo group. Significant between-group (normal-dose vs. placebo) differences were observed in body weight, BMI, body fat percentage, fat mass, and plasma ketone levels. Participants reported no D-BHB-related adverse effects or discomfort. In conclusion, 1.5 or 2.9 g/day of D-BHB may reduce body fat without dieting or exercise interventions.

]]> Effect of D-β-Hydroxybutyric Acid on Body Fat in Japanese Adults: A Randomized, Double-Blind, Placebo-Controlled Study Shohei Katsuya Yoshikazu Kawata Jun Kawamura Tsuyoshi Goto Tsuyoshi Takara Jun Tsubota doi: 10.3390/obesities5040082 Obesities 2025-11-14 Obesities 2025-11-14 5 4 Article 82 10.3390/obesities5040082 https://www.mdpi.com/2673-4168/5/4/82 Obesities, Vol. 5, Pages 81: Evaluation of Adiponectin as a Metabolic Risk Indicator in the Panamanian Population https://www.mdpi.com/2673-4168/5/4/81 Adiponectin, an adipokine secreted by adipocytes with anti-inflammatory and insulin-sensitizing properties, circulates in several isoforms, of which total and high-molecular-weight (HMW) adiponectin are the most physiologically relevant. While adiponectin has been inversely associated with obesity and metabolic syndrome (MetS), evidence from Latin American populations remains scarce. To explore its role in this context, we conducted a case–control study in 310 Panamanian adults, including 77 individuals with MetS and 233 controls, diagnosed according to the Latin American Diabetes Association (ALAD) criteria. Serum adiponectin, lipid profile, glucose, HbA1c, and body composition were evaluated, with adiponectin quantified by chemiluminescent immunoassay (CLIA). Correlations with metabolic parameters were analyzed using GraphPad Prism 10.5. Participants with MetS exhibited significantly lower adiponectin concentrations compared with controls (7.75 ± 2.58 µg/mL vs. 9.53 ± 3.31 µg/mL, p = 0.0030). Adiponectin levels were significantly lower in males than in females (p = 0.0083) and showed inverse correlations with visceral fat (r = −0.26, p < 0.001), triglycerides (r = −0.25, p = 0.0062), insulin (r = −0.31, p < 0.0001), and HbA1c (r = −0.11, p = 0.046). Conversely, a positive association was observed with HDL cholesterol (r = 0.37, p < 0.0001). Individuals with HbA1c ≥ 6.5% or insulin ≥ 15 µU/mL exhibited markedly reduced adiponectin concentrations (p = 0.0006 and p < 0.0001, respectively). The ROC analysis yielded an AUC of 0.69, indicating a moderate discriminatory ability of adiponectin for identifying MetS in this population. These findings confirm that adiponectin is inversely associated with several metabolic risk factors, supporting its potential utility as a biomarker for early detection and risk stratification of metabolic syndrome in the Panamanian population. 2025-11-14 Obesities, Vol. 5, Pages 81: Evaluation of Adiponectin as a Metabolic Risk Indicator in the Panamanian Population

Obesities doi: 10.3390/obesities5040081

Authors: Orlando Serrano Garrido Xenia Hernandez Adames Ivonne Torres-Atencio Ana Espinosa De Ycaza Maria Fabiana Piran Arce Ana Tejada Espinosa Griselda Arteaga

Adiponectin, an adipokine secreted by adipocytes with anti-inflammatory and insulin-sensitizing properties, circulates in several isoforms, of which total and high-molecular-weight (HMW) adiponectin are the most physiologically relevant. While adiponectin has been inversely associated with obesity and metabolic syndrome (MetS), evidence from Latin American populations remains scarce. To explore its role in this context, we conducted a case–control study in 310 Panamanian adults, including 77 individuals with MetS and 233 controls, diagnosed according to the Latin American Diabetes Association (ALAD) criteria. Serum adiponectin, lipid profile, glucose, HbA1c, and body composition were evaluated, with adiponectin quantified by chemiluminescent immunoassay (CLIA). Correlations with metabolic parameters were analyzed using GraphPad Prism 10.5. Participants with MetS exhibited significantly lower adiponectin concentrations compared with controls (7.75 ± 2.58 µg/mL vs. 9.53 ± 3.31 µg/mL, p = 0.0030). Adiponectin levels were significantly lower in males than in females (p = 0.0083) and showed inverse correlations with visceral fat (r = −0.26, p < 0.001), triglycerides (r = −0.25, p = 0.0062), insulin (r = −0.31, p < 0.0001), and HbA1c (r = −0.11, p = 0.046). Conversely, a positive association was observed with HDL cholesterol (r = 0.37, p < 0.0001). Individuals with HbA1c ≥ 6.5% or insulin ≥ 15 µU/mL exhibited markedly reduced adiponectin concentrations (p = 0.0006 and p < 0.0001, respectively). The ROC analysis yielded an AUC of 0.69, indicating a moderate discriminatory ability of adiponectin for identifying MetS in this population. These findings confirm that adiponectin is inversely associated with several metabolic risk factors, supporting its potential utility as a biomarker for early detection and risk stratification of metabolic syndrome in the Panamanian population.

]]> Evaluation of Adiponectin as a Metabolic Risk Indicator in the Panamanian Population Orlando Serrano Garrido Xenia Hernandez Adames Ivonne Torres-Atencio Ana Espinosa De Ycaza Maria Fabiana Piran Arce Ana Tejada Espinosa Griselda Arteaga doi: 10.3390/obesities5040081 Obesities 2025-11-14 Obesities 2025-11-14 5 4 Article 81 10.3390/obesities5040081 https://www.mdpi.com/2673-4168/5/4/81 Obesities, Vol. 5, Pages 80: Prevalence of Arterial Hypertension and Associated Factors Among Female Workers in a Large Company in Southern Brazil https://www.mdpi.com/2673-4168/5/4/80 Background/Objectives: Systemic arterial hypertension (SAH) is a multifactorial condition strongly associated with increased morbidity and mortality. This study aimed to investigate the prevalence of SAH and its associated factors among female workers in a large company in Southern Brazil. Methods: A cross-sectional study was conducted with a sample of 451 female workers aged 18 years or older. Blood pressure (BP) was measured using an automated digital upper-arm device. SAH was defined as systolic BP and/or diastolic BP ≥ 140/90 mmHg or the use of antihypertensive medications. Prevalence ratios were estimated using Poisson regression with robust variance. Results: The mean age of the sample was 35 ± 10 years. The prevalence of SAH was 27.7% (95% CI: 23.6–31.9). Among workers with obesity (BMI ≥ 30 kg/m2), the prevalence of SAH reached 42.8%. In multivariable-adjusted models, workers aged ≥41 years had a 48% higher probability of having SAH (PR = 1.48; 95% CI: 1.01–2.18) compared with younger women (18–30 years). Conversely, a 52% lower probability of SAH was observed among workers with higher monthly per capita income (>2 minimum wages) compared with those earning <1 minimum wage (PR = 0.48; 95% CI: 0.28–0.80). Obesity was associated with an 85% increased probability of SAH (PR = 1.85; 95% CI: 1.30–2.47). Conclusions: The findings of this study revealed that SAH is prevalent in this specific population of female workers, particularly among older women and those with obesity. 2025-11-13 Obesities, Vol. 5, Pages 80: Prevalence of Arterial Hypertension and Associated Factors Among Female Workers in a Large Company in Southern Brazil

Obesities doi: 10.3390/obesities5040080

Authors: Yasmin Garcia Marinho Harrison Canabarro Arruda Ingrid Stähler Kohl Janaína Cristina da Silva Anderson Garcez Maria Teresa Anselmo Olinto

Background/Objectives: Systemic arterial hypertension (SAH) is a multifactorial condition strongly associated with increased morbidity and mortality. This study aimed to investigate the prevalence of SAH and its associated factors among female workers in a large company in Southern Brazil. Methods: A cross-sectional study was conducted with a sample of 451 female workers aged 18 years or older. Blood pressure (BP) was measured using an automated digital upper-arm device. SAH was defined as systolic BP and/or diastolic BP ≥ 140/90 mmHg or the use of antihypertensive medications. Prevalence ratios were estimated using Poisson regression with robust variance. Results: The mean age of the sample was 35 ± 10 years. The prevalence of SAH was 27.7% (95% CI: 23.6–31.9). Among workers with obesity (BMI ≥ 30 kg/m2), the prevalence of SAH reached 42.8%. In multivariable-adjusted models, workers aged ≥41 years had a 48% higher probability of having SAH (PR = 1.48; 95% CI: 1.01–2.18) compared with younger women (18–30 years). Conversely, a 52% lower probability of SAH was observed among workers with higher monthly per capita income (>2 minimum wages) compared with those earning <1 minimum wage (PR = 0.48; 95% CI: 0.28–0.80). Obesity was associated with an 85% increased probability of SAH (PR = 1.85; 95% CI: 1.30–2.47). Conclusions: The findings of this study revealed that SAH is prevalent in this specific population of female workers, particularly among older women and those with obesity.

]]> Prevalence of Arterial Hypertension and Associated Factors Among Female Workers in a Large Company in Southern Brazil Yasmin Garcia Marinho Harrison Canabarro Arruda Ingrid Stähler Kohl Janaína Cristina da Silva Anderson Garcez Maria Teresa Anselmo Olinto doi: 10.3390/obesities5040080 Obesities 2025-11-13 Obesities 2025-11-13 5 4 Article 80 10.3390/obesities5040080 https://www.mdpi.com/2673-4168/5/4/80 Obesities, Vol. 5, Pages 79: Lifestyle Interventions for the Treatment of Obesity in Workers: An Integrative Review https://www.mdpi.com/2673-4168/5/4/79 Background: Obesity is a multifactorial disease with significant physical, psychological, and economic impacts on individuals and society. Workers are particularly vulnerable, as obesity is associated with reduced productivity, absenteeism, and premature mortality. Lifestyle interventions combining dietary, physical activity, and behavioural strategies have been investigated as therapeutic approaches in this population. Objective: We aimed to conduct an integrative review assessing the effectiveness of workplace-based obesity treatment models involving dietary interventions, physical activity, and behavioural change. Methods: A search was conducted in PubMed for studies published between 2006 and 2024, with no language restrictions. Eligible studies included experimental or quasi-experimental longitudinal designs involving adult workers. After screening 95 articles, 18 were evaluated in full, and 8 met all inclusion criteria. Data extraction covered study design, intervention type, comparators, outcomes, and methodological quality, assessed using the Newcastle–Ottawa Scale. Results: Half of the included studies reported no significant reduction in body mass index after 6 or 12 months, while the others showed only modest decreases. Nevertheless, all interventions demonstrated improvements in dietary habits (reduced sugar-sweetened beverage intake, increased fruit, vegetable, and fibre consumption), physical activity (increased walking, reduced sedentary behaviour), and behavioural domains (adherence to healthy routines, self-monitoring, and family or employer support). Conclusions: Lifestyle-based workplace interventions for obesity show limited long-term effectiveness in weight reduction but promote healthier lifestyle habits, cardiometabolic health, and more supportive work environments. Future research should include diverse socioeconomic settings, particularly in developing countries, and apply robust designs, longer follow-ups, and innovative strategies to enhance adherence and outcomes. 2025-11-11 Obesities, Vol. 5, Pages 79: Lifestyle Interventions for the Treatment of Obesity in Workers: An Integrative Review

Obesities doi: 10.3390/obesities5040079

Authors: Marcia Cristina Almeida Magalhães Oliveira Julia Passo Machado Neto Viana Sergio de Queiroz Braga Magno Merces Weyll Pimentel

Background: Obesity is a multifactorial disease with significant physical, psychological, and economic impacts on individuals and society. Workers are particularly vulnerable, as obesity is associated with reduced productivity, absenteeism, and premature mortality. Lifestyle interventions combining dietary, physical activity, and behavioural strategies have been investigated as therapeutic approaches in this population. Objective: We aimed to conduct an integrative review assessing the effectiveness of workplace-based obesity treatment models involving dietary interventions, physical activity, and behavioural change. Methods: A search was conducted in PubMed for studies published between 2006 and 2024, with no language restrictions. Eligible studies included experimental or quasi-experimental longitudinal designs involving adult workers. After screening 95 articles, 18 were evaluated in full, and 8 met all inclusion criteria. Data extraction covered study design, intervention type, comparators, outcomes, and methodological quality, assessed using the Newcastle–Ottawa Scale. Results: Half of the included studies reported no significant reduction in body mass index after 6 or 12 months, while the others showed only modest decreases. Nevertheless, all interventions demonstrated improvements in dietary habits (reduced sugar-sweetened beverage intake, increased fruit, vegetable, and fibre consumption), physical activity (increased walking, reduced sedentary behaviour), and behavioural domains (adherence to healthy routines, self-monitoring, and family or employer support). Conclusions: Lifestyle-based workplace interventions for obesity show limited long-term effectiveness in weight reduction but promote healthier lifestyle habits, cardiometabolic health, and more supportive work environments. Future research should include diverse socioeconomic settings, particularly in developing countries, and apply robust designs, longer follow-ups, and innovative strategies to enhance adherence and outcomes.

]]> Lifestyle Interventions for the Treatment of Obesity in Workers: An Integrative Review Marcia Cristina Almeida Magalhães Oliveira Julia Passo Machado Neto Viana Sergio de Queiroz Braga Magno Merces Weyll Pimentel doi: 10.3390/obesities5040079 Obesities 2025-11-11 Obesities 2025-11-11 5 4 Review 79 10.3390/obesities5040079 https://www.mdpi.com/2673-4168/5/4/79 Obesities, Vol. 5, Pages 78: Stages of Change and Variation in Weight-Related Behaviors and Physical Activity: The Role of Motivation and Self-Efficacy in Adolescents https://www.mdpi.com/2673-4168/5/4/78 The stages of change have been identified as a valuable framework for understanding the transition toward a healthy lifestyle. It is also important to recognize change through other psychosocial variables, such as motivation and self-efficacy. The objective of this study was to explore weight control over the course of an academic year (nine months) through three behaviors: the stage of change toward weight control (pre-contemplation, contemplation, preparation, action, maintenance), healthy and unhealthy eating behaviors for weight control, and the frequency of physical activity (PA). Furthermore, we wanted to ascertain whether the three distinct types of motivation (autonomous, controlled, and amotivation) and self-efficacy could account for fluctuations in weight control over time. The sample consisted of 303 adolescents (205 female and 98 male) between the ages of 15 and 23 (M = 17.26; SD = 1.65). Chi-square, t-test, and multiple linear stepwise regression analysis were employed. The results indicated that a higher proportion of adolescents were in the precontemplation and action stages at Time 2. Concurrently, an increase in the frequency of moderate-to-vigorous PA and an increase in healthy and unhealthy behaviors were observed during the school period. The present study posits that autonomous motivation, controlled motivation, and self-efficacy can explain healthy eating behaviors for weight control and the frequency of moderate-to-vigorous PA, while only controlled motivation explains unhealthy eating behaviors for weight control. The conclusion of the study points out that healthy behaviors can change over time due to individual regulation of motivation and increased self-perception of efficacy in one’s own abilities to perform a specific action to control weight. 2025-10-30 Obesities, Vol. 5, Pages 78: Stages of Change and Variation in Weight-Related Behaviors and Physical Activity: The Role of Motivation and Self-Efficacy in Adolescents

Obesities doi: 10.3390/obesities5040078

Authors: María Marentes-Castillo Isabel Castillo Inés Tomás Octavio Álvarez

The stages of change have been identified as a valuable framework for understanding the transition toward a healthy lifestyle. It is also important to recognize change through other psychosocial variables, such as motivation and self-efficacy. The objective of this study was to explore weight control over the course of an academic year (nine months) through three behaviors: the stage of change toward weight control (pre-contemplation, contemplation, preparation, action, maintenance), healthy and unhealthy eating behaviors for weight control, and the frequency of physical activity (PA). Furthermore, we wanted to ascertain whether the three distinct types of motivation (autonomous, controlled, and amotivation) and self-efficacy could account for fluctuations in weight control over time. The sample consisted of 303 adolescents (205 female and 98 male) between the ages of 15 and 23 (M = 17.26; SD = 1.65). Chi-square, t-test, and multiple linear stepwise regression analysis were employed. The results indicated that a higher proportion of adolescents were in the precontemplation and action stages at Time 2. Concurrently, an increase in the frequency of moderate-to-vigorous PA and an increase in healthy and unhealthy behaviors were observed during the school period. The present study posits that autonomous motivation, controlled motivation, and self-efficacy can explain healthy eating behaviors for weight control and the frequency of moderate-to-vigorous PA, while only controlled motivation explains unhealthy eating behaviors for weight control. The conclusion of the study points out that healthy behaviors can change over time due to individual regulation of motivation and increased self-perception of efficacy in one’s own abilities to perform a specific action to control weight.

]]> Stages of Change and Variation in Weight-Related Behaviors and Physical Activity: The Role of Motivation and Self-Efficacy in Adolescents María Marentes-Castillo Isabel Castillo Inés Tomás Octavio Álvarez doi: 10.3390/obesities5040078 Obesities 2025-10-30 Obesities 2025-10-30 5 4 Article 78 10.3390/obesities5040078 https://www.mdpi.com/2673-4168/5/4/78 Obesities, Vol. 5, Pages 77: Impact of a Vegetarian Diet upon Premature Aging, Metabolic Syndrome, and Health https://www.mdpi.com/2673-4168/5/4/77 Objective: This study aimed to evaluate the impact of an exclusively vegetarian diet, combined with physical activity and lifestyle interventions, on metabolic parameters in patients with metabolic syndrome, with a focus on preventing premature aging and improving overall health status. Materials and Methods: A total of 150 participants (82 females, 68 males; aged 36–80 years, with a mean age of 61.45 years) diagnosed with metabolic syndrome were enrolled. Participants followed an exclusively vegetarian diet (≈2100 kcal/day; 65% carbohydrates, 23% lipids, 15% proteins, 52.4 g dietary fiber, and 0 mg cholesterol) along with a structured lifestyle program that included physical activity (2.5 h/day, intensity 2–6 METs), psychological counseling, smoking cessation support, weight and blood pressure management, hydrotherapy, massage, phytotherapy, and stress-reduction sessions. Baseline and post-intervention assessments were performed to measure total cholesterol, LDL, HDL, triglycerides, glycemia, BMI, and blood pressure. Results: After 10 days of intervention, significant improvements were observed across all measured parameters: total cholesterol decreased by 41.21 mg/dL (−19.54%), triglycerides decreased by 72.86 mg/dL (−34.9%), LDL cholesterol decreased by 26.24 mg/dL (−19.71%), fasting glycemia decreased by 30.4 mg/dL (−21.61%), BMI decreased by 3%, systolic blood pressure decreased by 10.82 mmHg, and diastolic blood pressure decreased by 6.44 mmHg. Conclusions: Our findings demonstrate that a structured lifestyle intervention, centered on a vegetarian diet and physical activity, has a significant beneficial effect on metabolic health. This approach improves cardiovascular risk factors, glycemic control, and body composition, and may play a preventive role against premature aging. 2025-10-27 Obesities, Vol. 5, Pages 77: Impact of a Vegetarian Diet upon Premature Aging, Metabolic Syndrome, and Health

Obesities doi: 10.3390/obesities5040077

Authors: Oana Codruta Bacean Miloicov Georgiana Patricia Sitaru Gabriel Cristian Vacaru Ciprian Ioan Borca Mihaela Cristina Simbrac Roxana Folescu Daniela Gurgus Mirabela Anca Ursadan

Objective: This study aimed to evaluate the impact of an exclusively vegetarian diet, combined with physical activity and lifestyle interventions, on metabolic parameters in patients with metabolic syndrome, with a focus on preventing premature aging and improving overall health status. Materials and Methods: A total of 150 participants (82 females, 68 males; aged 36–80 years, with a mean age of 61.45 years) diagnosed with metabolic syndrome were enrolled. Participants followed an exclusively vegetarian diet (≈2100 kcal/day; 65% carbohydrates, 23% lipids, 15% proteins, 52.4 g dietary fiber, and 0 mg cholesterol) along with a structured lifestyle program that included physical activity (2.5 h/day, intensity 2–6 METs), psychological counseling, smoking cessation support, weight and blood pressure management, hydrotherapy, massage, phytotherapy, and stress-reduction sessions. Baseline and post-intervention assessments were performed to measure total cholesterol, LDL, HDL, triglycerides, glycemia, BMI, and blood pressure. Results: After 10 days of intervention, significant improvements were observed across all measured parameters: total cholesterol decreased by 41.21 mg/dL (−19.54%), triglycerides decreased by 72.86 mg/dL (−34.9%), LDL cholesterol decreased by 26.24 mg/dL (−19.71%), fasting glycemia decreased by 30.4 mg/dL (−21.61%), BMI decreased by 3%, systolic blood pressure decreased by 10.82 mmHg, and diastolic blood pressure decreased by 6.44 mmHg. Conclusions: Our findings demonstrate that a structured lifestyle intervention, centered on a vegetarian diet and physical activity, has a significant beneficial effect on metabolic health. This approach improves cardiovascular risk factors, glycemic control, and body composition, and may play a preventive role against premature aging.

]]> Impact of a Vegetarian Diet upon Premature Aging, Metabolic Syndrome, and Health Oana Codruta Bacean Miloicov Georgiana Patricia Sitaru Gabriel Cristian Vacaru Ciprian Ioan Borca Mihaela Cristina Simbrac Roxana Folescu Daniela Gurgus Mirabela Anca Ursadan doi: 10.3390/obesities5040077 Obesities 2025-10-27 Obesities 2025-10-27 5 4 Article 77 10.3390/obesities5040077 https://www.mdpi.com/2673-4168/5/4/77 Obesities, Vol. 5, Pages 76: The Prevalence and Correlates of Vitamin D Deficiency and Overweight/Obesity of School-Age Children in Colombia–Findings on the Double Burden of Malnutrition from Nationally-Representative Data https://www.mdpi.com/2673-4168/5/4/76 The double burden of malnutrition (DBM)—the coexistence of overweight/obesity and micronutrient deficiency—is an emerging public health concern among school-aged children. Using data from 6063 participants in Colombia’s 2015 National Survey of Nutritional Status (ENSIN), this study estimated DBM prevalence and identified factors associated with its occurrence among children aged 5–12 years. DBM was defined as concurrent overweight/obesity (BMI-for-age z-score > 1) and vitamin D deficiency, applying thresholds of <30, <37.5, and <50 nmol/L. The prevalence of DBM ranged from 0.7% to 6.9%. Firth’s penalized logistic regression models were conducted separately for (1) overweight/obese combined, (2) overweight-only, and (3) obesity-only groups. For DBM1, insufficient physical activity was linked to higher odds across all three models. For DBM2, smaller household size and higher maternal education were associated with greater odds in the combined model. Living in large urban areas was related to lower odds compared with major metropolitan areas, a pattern also observed in the overweight-only model. For DBM3, children from the second wealth quartile (Q2) showed higher odds than those from the poorest (Q1), with a similar pattern in the overweight-only analysis. Stricter DBM definitions tended to capture behavioral and household characteristics, whereas broader thresholds reflected structural and contextual conditions. Despite its relatively low prevalence, DBM remains a relevant public health issue among Colombian schoolchildren. 2025-10-24 Obesities, Vol. 5, Pages 76: The Prevalence and Correlates of Vitamin D Deficiency and Overweight/Obesity of School-Age Children in Colombia–Findings on the Double Burden of Malnutrition from Nationally-Representative Data

Obesities doi: 10.3390/obesities5040076

Authors: Edwin Guevara-Romero Victor Florez-Garcia Faith Ogungbe Amy Harley Alice Yan

The double burden of malnutrition (DBM)—the coexistence of overweight/obesity and micronutrient deficiency—is an emerging public health concern among school-aged children. Using data from 6063 participants in Colombia’s 2015 National Survey of Nutritional Status (ENSIN), this study estimated DBM prevalence and identified factors associated with its occurrence among children aged 5–12 years. DBM was defined as concurrent overweight/obesity (BMI-for-age z-score > 1) and vitamin D deficiency, applying thresholds of <30, <37.5, and <50 nmol/L. The prevalence of DBM ranged from 0.7% to 6.9%. Firth’s penalized logistic regression models were conducted separately for (1) overweight/obese combined, (2) overweight-only, and (3) obesity-only groups. For DBM1, insufficient physical activity was linked to higher odds across all three models. For DBM2, smaller household size and higher maternal education were associated with greater odds in the combined model. Living in large urban areas was related to lower odds compared with major metropolitan areas, a pattern also observed in the overweight-only model. For DBM3, children from the second wealth quartile (Q2) showed higher odds than those from the poorest (Q1), with a similar pattern in the overweight-only analysis. Stricter DBM definitions tended to capture behavioral and household characteristics, whereas broader thresholds reflected structural and contextual conditions. Despite its relatively low prevalence, DBM remains a relevant public health issue among Colombian schoolchildren.

]]> The Prevalence and Correlates of Vitamin D Deficiency and Overweight/Obesity of School-Age Children in Colombia–Findings on the Double Burden of Malnutrition from Nationally-Representative Data Edwin Guevara-Romero Victor Florez-Garcia Faith Ogungbe Amy Harley Alice Yan doi: 10.3390/obesities5040076 Obesities 2025-10-24 Obesities 2025-10-24 5 4 Article 76 10.3390/obesities5040076 https://www.mdpi.com/2673-4168/5/4/76 Obesities, Vol. 5, Pages 75: Blockade of the Proximal Pancreatic C Fiber Enhances Insulin Sensitivity in Rats https://www.mdpi.com/2673-4168/5/4/75 Numerous reports have been published on the putative mechanisms of development of insulin resistance in diabetes mellitus. However, no unified view has been established yet, especially in regard to involvement of the nervous system in the regulation of insulin sensitivity. In this study, we investigated the involvement of the autonomic nervous system in cellular glucose uptake by blocking Group C nerve fibers (C fibers) in the rat pancreas with capsaicin. When the junction of the proximal pancreatic duct and common bile duct was treated with capsaicin, glucose uptake was enhanced, probably due to increased insulin sensitivity. This suggests that capsaicin may partially block the vagal nerve fibers innervating the pancreas, resulting in enhanced insulin sensitivity. In other words, our finding suggests that pancreatic autonomic nerves may be involved in the regulation of insulin sensitivity and that partial blockade of these nerves may improve insulin sensitivity. 2025-10-16 Obesities, Vol. 5, Pages 75: Blockade of the Proximal Pancreatic C Fiber Enhances Insulin Sensitivity in Rats

Obesities doi: 10.3390/obesities5040075

Authors: Masataka Kusunoki Daisuke Sato Fumiya Hisano Kazuhiko Tsutsumi Tetsuro Miyata

Numerous reports have been published on the putative mechanisms of development of insulin resistance in diabetes mellitus. However, no unified view has been established yet, especially in regard to involvement of the nervous system in the regulation of insulin sensitivity. In this study, we investigated the involvement of the autonomic nervous system in cellular glucose uptake by blocking Group C nerve fibers (C fibers) in the rat pancreas with capsaicin. When the junction of the proximal pancreatic duct and common bile duct was treated with capsaicin, glucose uptake was enhanced, probably due to increased insulin sensitivity. This suggests that capsaicin may partially block the vagal nerve fibers innervating the pancreas, resulting in enhanced insulin sensitivity. In other words, our finding suggests that pancreatic autonomic nerves may be involved in the regulation of insulin sensitivity and that partial blockade of these nerves may improve insulin sensitivity.

]]> Blockade of the Proximal Pancreatic C Fiber Enhances Insulin Sensitivity in Rats Masataka Kusunoki Daisuke Sato Fumiya Hisano Kazuhiko Tsutsumi Tetsuro Miyata doi: 10.3390/obesities5040075 Obesities 2025-10-16 Obesities 2025-10-16 5 4 Communication 75 10.3390/obesities5040075 https://www.mdpi.com/2673-4168/5/4/75 Obesities, Vol. 5, Pages 74: Anti-Inflammatory Effects of L-Fucose in 3T3-L1 Adipocytes https://www.mdpi.com/2673-4168/5/4/74 L-fucose is a monosaccharide derived from brown algae and has potential applications as a functional food ingredient. Previous studies have reported that L-fucose reduces lipid accumulation in murine adipose tissue. Adipose tissue not only regulates energy metabolism but also functions as an endocrine organ involved in inflammation through the production and secretion of various adipokines. L-fucose is expected to exert anti-inflammatory effects and modulate adipokine secretion in adipocytes. In the present study, we investigated the anti-inflammatory effects of L-fucose in adipocytes. L-fucose significantly suppressed the expression of pro-inflammatory mediators and reduced the production of reactive oxygen species induced by inflammatory stimulation with a combination of lipopolysaccharide (LPS), tumor necrosis factor-⍺ (TNF-⍺), and interferon-γ (IFN-γ). These effects are likely mediated through the inhibition of key signaling pathways, including mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) pathways. Additionally, we found that L-fucose promoted the multimerization and secretion of high molecular weight (HMW) adiponectin, even under inflammatory conditions. Our results suggest that although L-fucose downregulates adiponectin expression, it contributes to the formation and/or stabilization of HMW adiponectin, which is functionally more relevant in anti-inflammatory and metabolic regulation. L-fucose thus holds promise as a functional food ingredient for mitigating inflammation in adipocytes. 2025-10-11 Obesities, Vol. 5, Pages 74: Anti-Inflammatory Effects of L-Fucose in 3T3-L1 Adipocytes

Obesities doi: 10.3390/obesities5040074

Authors: Tomoya Nakamura Tomohiko Nakao Kazuyuki Ohara Yuri Kominami Miho Ito Kazuki Mochizuki Teruki Aizawa Yusuke Akahori Tomoya Ueno Hideki Ushio

L-fucose is a monosaccharide derived from brown algae and has potential applications as a functional food ingredient. Previous studies have reported that L-fucose reduces lipid accumulation in murine adipose tissue. Adipose tissue not only regulates energy metabolism but also functions as an endocrine organ involved in inflammation through the production and secretion of various adipokines. L-fucose is expected to exert anti-inflammatory effects and modulate adipokine secretion in adipocytes. In the present study, we investigated the anti-inflammatory effects of L-fucose in adipocytes. L-fucose significantly suppressed the expression of pro-inflammatory mediators and reduced the production of reactive oxygen species induced by inflammatory stimulation with a combination of lipopolysaccharide (LPS), tumor necrosis factor-⍺ (TNF-⍺), and interferon-γ (IFN-γ). These effects are likely mediated through the inhibition of key signaling pathways, including mitogen-activated protein kinase (MAPK) and nuclear factor-kappa B (NF-κB) pathways. Additionally, we found that L-fucose promoted the multimerization and secretion of high molecular weight (HMW) adiponectin, even under inflammatory conditions. Our results suggest that although L-fucose downregulates adiponectin expression, it contributes to the formation and/or stabilization of HMW adiponectin, which is functionally more relevant in anti-inflammatory and metabolic regulation. L-fucose thus holds promise as a functional food ingredient for mitigating inflammation in adipocytes.

]]> Anti-Inflammatory Effects of L-Fucose in 3T3-L1 Adipocytes Tomoya Nakamura Tomohiko Nakao Kazuyuki Ohara Yuri Kominami Miho Ito Kazuki Mochizuki Teruki Aizawa Yusuke Akahori Tomoya Ueno Hideki Ushio doi: 10.3390/obesities5040074 Obesities 2025-10-11 Obesities 2025-10-11 5 4 Article 74 10.3390/obesities5040074 https://www.mdpi.com/2673-4168/5/4/74 Obesities, Vol. 5, Pages 73: Appetite Assessment Using the Arabic CNAQ Following a Telenutrition Weight-Loss Intervention with Health Coaching and Telemonitoring: A Cross-Sectional Analysis https://www.mdpi.com/2673-4168/5/4/73 Obesity is closely associated with appetite dysregulation, influenced by behavioral, hormonal, and neurological factors. The Council on Nutrition Appetite Questionnaire (CNAQ) is a validated tool, translated into Arabic, but its application in weight-loss interventions remains underexplored. This secondary cross-sectional analysis evaluated whether the Arabic CNAQ can differentiate appetite levels after a 6-month telenutrition weight-loss intervention supported by telemonitoring and health coaching, and whether appetite is associated with weight-loss outcomes. A total of 36 participants were assessed: the intervention group (n = 21), who completed the program, and the control group (n = 15), who received no continuous support. Appetite was measured using the CNAQ after 6 months. Independent-samples t-tests and Mann–Whitney U tests were applied to compare appetite scores, while Chi-square tests were used for appetite categories. Results showed mean CNAQ scores of 27.87 (SD = 2.64) for the control group and 26.86 (SD = 4.46) for the intervention group (p = 0.402). Most participants reported moderate appetite (93.3% control; 76.2% intervention), with no significant between-group differences (p = 0.367). Although differences were not statistically significant, the findings demonstrate the feasibility of using the Arabic CNAQ in telehealth weight management. Larger studies with repeated measures are needed to confirm its utility in clinical and dietetic practice. 2025-10-09 Obesities, Vol. 5, Pages 73: Appetite Assessment Using the Arabic CNAQ Following a Telenutrition Weight-Loss Intervention with Health Coaching and Telemonitoring: A Cross-Sectional Analysis

Obesities doi: 10.3390/obesities5040073

Authors: Sarah N. Alsharif Noura M. S. Eid Noor A. Hakim Najlaa M. M. Jawad Soaad F. Alsulami

Obesity is closely associated with appetite dysregulation, influenced by behavioral, hormonal, and neurological factors. The Council on Nutrition Appetite Questionnaire (CNAQ) is a validated tool, translated into Arabic, but its application in weight-loss interventions remains underexplored. This secondary cross-sectional analysis evaluated whether the Arabic CNAQ can differentiate appetite levels after a 6-month telenutrition weight-loss intervention supported by telemonitoring and health coaching, and whether appetite is associated with weight-loss outcomes. A total of 36 participants were assessed: the intervention group (n = 21), who completed the program, and the control group (n = 15), who received no continuous support. Appetite was measured using the CNAQ after 6 months. Independent-samples t-tests and Mann–Whitney U tests were applied to compare appetite scores, while Chi-square tests were used for appetite categories. Results showed mean CNAQ scores of 27.87 (SD = 2.64) for the control group and 26.86 (SD = 4.46) for the intervention group (p = 0.402). Most participants reported moderate appetite (93.3% control; 76.2% intervention), with no significant between-group differences (p = 0.367). Although differences were not statistically significant, the findings demonstrate the feasibility of using the Arabic CNAQ in telehealth weight management. Larger studies with repeated measures are needed to confirm its utility in clinical and dietetic practice.

]]> Appetite Assessment Using the Arabic CNAQ Following a Telenutrition Weight-Loss Intervention with Health Coaching and Telemonitoring: A Cross-Sectional Analysis Sarah N. Alsharif Noura M. S. Eid Noor A. Hakim Najlaa M. M. Jawad Soaad F. Alsulami doi: 10.3390/obesities5040073 Obesities 2025-10-09 Obesities 2025-10-09 5 4 Article 73 10.3390/obesities5040073 https://www.mdpi.com/2673-4168/5/4/73 Obesities, Vol. 5, Pages 72: Impacts of Glucagon-like Peptide-1 Receptor-Agonist (GLP-1 RA) Treatment for Metabolic Disturbances and Weight Gain in Patients on Clozapine/Olanzapine: A Systematic Review https://www.mdpi.com/2673-4168/5/4/72 Clozapine and olanzapine are important medications in the management of psychiatric conditions such as schizophrenia. However, metabolic disturbances and weight gain are common side effects of these drugs. We aimed to evaluate the effects of GLP-1 RAs treatment for metabolic disturbances and weight gain in patients on clozapine/olanzapine. For this systematic review, searches were conducted in eight different databases. After screening, outcome data was synthesized regarding weight gain and biochemical and clinical indicators of metabolic disturbance, as well as for adverse events/side effects, and any other benefits of GLP-1 RA treatment. A total of 14 studies were included in this medical systematic review, of which four were unique randomized control trials (RCTs), with study contexts including Australia and Denmark. GLP-1 RAs that were utilized include semaglutide, exenatide, and liraglutide. It was consistently demonstrated across studies that, when followed-up, those on GLP-1 RAs had achieved statistically lower levels of weight gain compared to those receiving placebo. A similar effect was seen on fasting glucose levels and glycated haemoglobin levels. Effects on other metabolic parameters were inconsistent. There were minimal gastrointestinal, psychological, cardiac, and other side effects noted across studies. GLP-1 RAs may offer utility in addressing the metabolic side effects of olanzapine/clozapine, but further research is needed. There remains a need to better understand impacts and potential side effects in larger and more diverse populations, as well as a need to better evaluate the long-term outcomes for patients. 2025-10-09 Obesities, Vol. 5, Pages 72: Impacts of Glucagon-like Peptide-1 Receptor-Agonist (GLP-1 RA) Treatment for Metabolic Disturbances and Weight Gain in Patients on Clozapine/Olanzapine: A Systematic Review

Obesities doi: 10.3390/obesities5040072

Authors: Karan Varshney Shivani Panda Hilary Fernando Sergiu Sava Taimur Khan

Clozapine and olanzapine are important medications in the management of psychiatric conditions such as schizophrenia. However, metabolic disturbances and weight gain are common side effects of these drugs. We aimed to evaluate the effects of GLP-1 RAs treatment for metabolic disturbances and weight gain in patients on clozapine/olanzapine. For this systematic review, searches were conducted in eight different databases. After screening, outcome data was synthesized regarding weight gain and biochemical and clinical indicators of metabolic disturbance, as well as for adverse events/side effects, and any other benefits of GLP-1 RA treatment. A total of 14 studies were included in this medical systematic review, of which four were unique randomized control trials (RCTs), with study contexts including Australia and Denmark. GLP-1 RAs that were utilized include semaglutide, exenatide, and liraglutide. It was consistently demonstrated across studies that, when followed-up, those on GLP-1 RAs had achieved statistically lower levels of weight gain compared to those receiving placebo. A similar effect was seen on fasting glucose levels and glycated haemoglobin levels. Effects on other metabolic parameters were inconsistent. There were minimal gastrointestinal, psychological, cardiac, and other side effects noted across studies. GLP-1 RAs may offer utility in addressing the metabolic side effects of olanzapine/clozapine, but further research is needed. There remains a need to better understand impacts and potential side effects in larger and more diverse populations, as well as a need to better evaluate the long-term outcomes for patients.

]]> Impacts of Glucagon-like Peptide-1 Receptor-Agonist (GLP-1 RA) Treatment for Metabolic Disturbances and Weight Gain in Patients on Clozapine/Olanzapine: A Systematic Review Karan Varshney Shivani Panda Hilary Fernando Sergiu Sava Taimur Khan doi: 10.3390/obesities5040072 Obesities 2025-10-09 Obesities 2025-10-09 5 4 Systematic Review 72 10.3390/obesities5040072 https://www.mdpi.com/2673-4168/5/4/72 Obesities, Vol. 5, Pages 71: Body Mapping as Risk Factors for Non-Communicable Diseases in Ghana: Evidence from Ghana’s 2023 Nationwide Steps Survey https://www.mdpi.com/2673-4168/5/4/71 Non-communicable diseases (NCDs) are the leading global cause of death, causing over 43 million deaths in 2021, including 18 million premature deaths, disproportionately affecting low- and middle-income countries. NCDs also incur significant economic losses, estimated at USD 7 trillion from 2011 to 2025, despite low prevention costs. This study evaluated body mapping indicators: body mass index (BMI), waist circumference, and waist-to-hip ratio—for predicting NCD risk, including hypertension, diabetes, and cardiovascular diseases, using data from a nationally representative survey in Ghana. The study sampled 5775 participants via multistage stratified sampling, ensuring proportional representation by region, urban/rural residency, age, and gender. Ethical approval and informed consent were obtained. Anthropometric and biochemical data, including height, weight, waist and hip circumferences, blood pressure, fasting glucose, and lipid profiles, were collected using standardized protocols. Data analysis was conducted with STATA 17.0, accounting for complex survey design. Significant sex-based differences were observed: men were taller and lighter, while women had higher BMI and waist/hip circumferences. NCD prevalence increased with age, peaking at 60–69 years, and was higher in females. Lower education and marital status (widowed, divorced, separated) correlated with higher NCD prevalence. Obesity and high waist circumference strongly predicted NCD risk, but individual anthropometric measures lacked screening accuracy. Integrated screening and tailored interventions are recommended for improved NCD detection and management in resource-limited settings. 2025-10-03 Obesities, Vol. 5, Pages 71: Body Mapping as Risk Factors for Non-Communicable Diseases in Ghana: Evidence from Ghana’s 2023 Nationwide Steps Survey

Obesities doi: 10.3390/obesities5040071

Authors: Pascal Kingsley Mwin Benjamin Demah Nuertey Joana Ansong Edmond Banafo Nartey Leveana Gyimah Philip Teg-Nefaah Tabong Emmanuel Parbie Abbeyquaye Priscilla Foriwaa Eshun Yaw Ampem Amoako Terence Totah Frank John Lule Sybil Sory Opoku Asiedu Abraham Hodgson

Non-communicable diseases (NCDs) are the leading global cause of death, causing over 43 million deaths in 2021, including 18 million premature deaths, disproportionately affecting low- and middle-income countries. NCDs also incur significant economic losses, estimated at USD 7 trillion from 2011 to 2025, despite low prevention costs. This study evaluated body mapping indicators: body mass index (BMI), waist circumference, and waist-to-hip ratio—for predicting NCD risk, including hypertension, diabetes, and cardiovascular diseases, using data from a nationally representative survey in Ghana. The study sampled 5775 participants via multistage stratified sampling, ensuring proportional representation by region, urban/rural residency, age, and gender. Ethical approval and informed consent were obtained. Anthropometric and biochemical data, including height, weight, waist and hip circumferences, blood pressure, fasting glucose, and lipid profiles, were collected using standardized protocols. Data analysis was conducted with STATA 17.0, accounting for complex survey design. Significant sex-based differences were observed: men were taller and lighter, while women had higher BMI and waist/hip circumferences. NCD prevalence increased with age, peaking at 60–69 years, and was higher in females. Lower education and marital status (widowed, divorced, separated) correlated with higher NCD prevalence. Obesity and high waist circumference strongly predicted NCD risk, but individual anthropometric measures lacked screening accuracy. Integrated screening and tailored interventions are recommended for improved NCD detection and management in resource-limited settings.

]]> Body Mapping as Risk Factors for Non-Communicable Diseases in Ghana: Evidence from Ghana’s 2023 Nationwide Steps Survey Pascal Kingsley Mwin Benjamin Demah Nuertey Joana Ansong Edmond Banafo Nartey Leveana Gyimah Philip Teg-Nefaah Tabong Emmanuel Parbie Abbeyquaye Priscilla Foriwaa Eshun Yaw Ampem Amoako Terence Totah Frank John Lule Sybil Sory Opoku Asiedu Abraham Hodgson doi: 10.3390/obesities5040071 Obesities 2025-10-03 Obesities 2025-10-03 5 4 Article 71 10.3390/obesities5040071 https://www.mdpi.com/2673-4168/5/4/71 Obesities, Vol. 5, Pages 70: The Magnitude of Dyslipidemia and Factors Associated with Elevated LDL-C Among Black South Africans with Type 2 Diabetes Mellitus at a Tertiary Hospital https://www.mdpi.com/2673-4168/5/4/70 Background/Objectives: Type 2 diabetes mellitus (T2DM) is a major global public health challenge with a significant impact on human life. The current study aims to provide a comprehensive analysis of the magnitude of dyslipidemia and the factors associated with elevated LDL-C levels among Black South Africans with T2DM. Methods: This was a cross-sectional study conducted in a tertiary hospital. Blood samples for glycated hemoglobin (HbA1c) and lipid profile were collected from the study participants and analyzed using Siemens Atellica™ analyzer. The data was entered into Microsoft excel and analyzed using SPSS version 24. Bivariate and multivariate logistic regression was employed to identify variables significantly associated with the outcomes, with a p-value  ≤  0.05 and a 95% confidence interval. Results: A total of 194 study participants with T2DM were recruited in the study. The overall prevalence of dyslipidemia was 90.72%. Of those with dyslipidemia, 40.9% had an isolated dyslipidemia, 39.7% had a combined dyslipidemia and 19.3% had atherogenic dyslipidemia. Significant factors associated with elevated levels of LDL-C included age, non-adherence to treatment (NAT) and duration. However, after multivariate analysis, NAT was found to be an independent associated factor with elevated levels of LDL-C (AOR: 4.596; 95% CI: 0.177–2.874; p = 0.027). Conclusions: Our study found that dyslipidemia is highly prevalent among Black South African patients with T2DM at a tertiary hospital, despite the use of lipid-lowering therapy. NAT was significantly associated with elevated levels of LDL-C. However, it is important to note that the study employed a cross-sectional design, conducted at a single hospital, which may impair the generalizability of the findings. 2025-09-27 Obesities, Vol. 5, Pages 70: The Magnitude of Dyslipidemia and Factors Associated with Elevated LDL-C Among Black South Africans with Type 2 Diabetes Mellitus at a Tertiary Hospital

Obesities doi: 10.3390/obesities5040070

Authors: Mashudu Nemukula Siphesihle Mkhwanazi Tumelo Jessica Mapheto Arun Kumar Malaisamy Neel Sarovar Bhavesh Olebogeng Harold Majane Sechene Stanley Gololo

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a major global public health challenge with a significant impact on human life. The current study aims to provide a comprehensive analysis of the magnitude of dyslipidemia and the factors associated with elevated LDL-C levels among Black South Africans with T2DM. Methods: This was a cross-sectional study conducted in a tertiary hospital. Blood samples for glycated hemoglobin (HbA1c) and lipid profile were collected from the study participants and analyzed using Siemens Atellica™ analyzer. The data was entered into Microsoft excel and analyzed using SPSS version 24. Bivariate and multivariate logistic regression was employed to identify variables significantly associated with the outcomes, with a p-value  ≤  0.05 and a 95% confidence interval. Results: A total of 194 study participants with T2DM were recruited in the study. The overall prevalence of dyslipidemia was 90.72%. Of those with dyslipidemia, 40.9% had an isolated dyslipidemia, 39.7% had a combined dyslipidemia and 19.3% had atherogenic dyslipidemia. Significant factors associated with elevated levels of LDL-C included age, non-adherence to treatment (NAT) and duration. However, after multivariate analysis, NAT was found to be an independent associated factor with elevated levels of LDL-C (AOR: 4.596; 95% CI: 0.177–2.874; p = 0.027). Conclusions: Our study found that dyslipidemia is highly prevalent among Black South African patients with T2DM at a tertiary hospital, despite the use of lipid-lowering therapy. NAT was significantly associated with elevated levels of LDL-C. However, it is important to note that the study employed a cross-sectional design, conducted at a single hospital, which may impair the generalizability of the findings.

]]> The Magnitude of Dyslipidemia and Factors Associated with Elevated LDL-C Among Black South Africans with Type 2 Diabetes Mellitus at a Tertiary Hospital Mashudu Nemukula Siphesihle Mkhwanazi Tumelo Jessica Mapheto Arun Kumar Malaisamy Neel Sarovar Bhavesh Olebogeng Harold Majane Sechene Stanley Gololo doi: 10.3390/obesities5040070 Obesities 2025-09-27 Obesities 2025-09-27 5 4 Article 70 10.3390/obesities5040070 https://www.mdpi.com/2673-4168/5/4/70 Obesities, Vol. 5, Pages 69: The Relationship of Education Level, Lifestyle, and Personality to BMI and Obesity Differs Between Men and Women https://www.mdpi.com/2673-4168/5/4/69 Obesity has become a major global health concern, but few studies have examined the determinants of body mass index (BMI, kg/m2) and overweight/obesity (BMI ≥ 25) specifically in women. This study investigated the roles of education, lifestyle, and personality using data from a questionnaire survey of 4276 Japanese adults (2215 women and 2061 men) aged 30–79 years. Multiple regression and logistic regression analyses were conducted to identify factors associated with BMI (continuous) and obesity (BMI ≥ 25) in women. The multiple regression results indicated that educational attainment, rest, diet, and conscientiousness were negatively associated with BMI, whereas extraversion and openness were positively associated with BMI. Logistic regression further showed that higher education, regular exercise, sufficient rest, and conscientiousness were associated with non-obesity (BMI < 25), while openness was associated with obesity (BMI ≥ 25). To our knowledge, this is the first study to identify determinants of BMI and obesity in women with a simultaneous focus on education, lifestyle, and personality traits. 2025-09-26 Obesities, Vol. 5, Pages 69: The Relationship of Education Level, Lifestyle, and Personality to BMI and Obesity Differs Between Men and Women

Obesities doi: 10.3390/obesities5040069

Authors: Keisuke Kokubun Kiyotaka Nemoto Yoshinori Yamakawa

Obesity has become a major global health concern, but few studies have examined the determinants of body mass index (BMI, kg/m2) and overweight/obesity (BMI ≥ 25) specifically in women. This study investigated the roles of education, lifestyle, and personality using data from a questionnaire survey of 4276 Japanese adults (2215 women and 2061 men) aged 30–79 years. Multiple regression and logistic regression analyses were conducted to identify factors associated with BMI (continuous) and obesity (BMI ≥ 25) in women. The multiple regression results indicated that educational attainment, rest, diet, and conscientiousness were negatively associated with BMI, whereas extraversion and openness were positively associated with BMI. Logistic regression further showed that higher education, regular exercise, sufficient rest, and conscientiousness were associated with non-obesity (BMI < 25), while openness was associated with obesity (BMI ≥ 25). To our knowledge, this is the first study to identify determinants of BMI and obesity in women with a simultaneous focus on education, lifestyle, and personality traits.

]]> The Relationship of Education Level, Lifestyle, and Personality to BMI and Obesity Differs Between Men and Women Keisuke Kokubun Kiyotaka Nemoto Yoshinori Yamakawa doi: 10.3390/obesities5040069 Obesities 2025-09-26 Obesities 2025-09-26 5 4 Article 69 10.3390/obesities5040069 https://www.mdpi.com/2673-4168/5/4/69 Obesities, Vol. 5, Pages 68: The Combined Effect of the Mediterranean Diet and Physical Activity on the Components of Metabolic Syndrome in Adults: A Systematic Review of Randomised Controlled Trials https://www.mdpi.com/2673-4168/5/4/68 Metabolic syndrome (MetS) is a global public health challenge, characterized by the coexistence of cardiometabolic risk factors such as abdominal obesity, dyslipidaemia, hypertension, and insulin resistance. Non-pharmacological strategies, including the Mediterranean diet (MD) and physical activity (PA), have been widely studied for their potential to prevent and manage MetS. This systematic review aimed to synthesize the evidence on the combined effect of MD and PA on MetS components in adults, based on randomized controlled trials (RCTs). Twenty-two RCTs published between 2018 and 2024 were included, involving 11,478 participants. The interventions ranged from 8 weeks to 3 years and combined adapted or hypocaloric MDs with moderate-to-high-intensity PA, typically including walking, aerobic exercise, or high-intensity interval training (HIIT), performed 3 to 7 times per week. The combined interventions resulted in reductions in body weight (−2.5 to −7.2 kg), body mass index (−0.7 to −2.2 kg/m2), waist circumference (−5.1 to −7.8 cm), and blood pressure (up to −9.0 mmHg systolic and −6.7 mmHg diastolic). Improvements in HDL cholesterol, triglyceride levels, and insulin sensitivity were also observed. These findings suggest that integrated interventions based on the Mediterranean lifestyle are effective in reducing MetS components and may support future public health strategies. 2025-09-25 Obesities, Vol. 5, Pages 68: The Combined Effect of the Mediterranean Diet and Physical Activity on the Components of Metabolic Syndrome in Adults: A Systematic Review of Randomised Controlled Trials

Obesities doi: 10.3390/obesities5040068

Authors: Luiza Teixeira Diogo Monteiro Rui Matos Raúl Antunes Miguel Jacinto

Metabolic syndrome (MetS) is a global public health challenge, characterized by the coexistence of cardiometabolic risk factors such as abdominal obesity, dyslipidaemia, hypertension, and insulin resistance. Non-pharmacological strategies, including the Mediterranean diet (MD) and physical activity (PA), have been widely studied for their potential to prevent and manage MetS. This systematic review aimed to synthesize the evidence on the combined effect of MD and PA on MetS components in adults, based on randomized controlled trials (RCTs). Twenty-two RCTs published between 2018 and 2024 were included, involving 11,478 participants. The interventions ranged from 8 weeks to 3 years and combined adapted or hypocaloric MDs with moderate-to-high-intensity PA, typically including walking, aerobic exercise, or high-intensity interval training (HIIT), performed 3 to 7 times per week. The combined interventions resulted in reductions in body weight (−2.5 to −7.2 kg), body mass index (−0.7 to −2.2 kg/m2), waist circumference (−5.1 to −7.8 cm), and blood pressure (up to −9.0 mmHg systolic and −6.7 mmHg diastolic). Improvements in HDL cholesterol, triglyceride levels, and insulin sensitivity were also observed. These findings suggest that integrated interventions based on the Mediterranean lifestyle are effective in reducing MetS components and may support future public health strategies.

]]> The Combined Effect of the Mediterranean Diet and Physical Activity on the Components of Metabolic Syndrome in Adults: A Systematic Review of Randomised Controlled Trials Luiza Teixeira Diogo Monteiro Rui Matos Raúl Antunes Miguel Jacinto doi: 10.3390/obesities5040068 Obesities 2025-09-25 Obesities 2025-09-25 5 4 Systematic Review 68 10.3390/obesities5040068 https://www.mdpi.com/2673-4168/5/4/68 Obesities, Vol. 5, Pages 67: Supplementation Effects of Hibiscus sabdariffa L. Flower Aqueous Extract on Body Composition and Metabolism in Eutrophic and Obese Rats https://www.mdpi.com/2673-4168/5/4/67 Obesity is a chronic, multifactorial disease characterized by excess body fat and is a major risk factor for various metabolic disorders. Bioactive compounds from the diet have been recognized for their role in preventing chronic non-communicable diseases and as adjuvants in managing endocrine–metabolic dysfunctions. Hibiscus sabdariffa L. (HSL) is rich in bioactive compounds with antioxidant, antihypertensive, and antihyperlipidemic properties. This study evaluated the effects of HSL flower extract supplementation on body composition, lipid profile, and biochemical parameters in both eutrophic and high-fat diet-induced obese rats. Thirty-two Wistar rats were assigned to four groups: control, control plus HSL extract, high-fat diet, and high-fat diet plus HSL extract. The extract was administered orally at 150 mg kg−1 for thirty days. Dual-energy X-ray absorptiometry revealed that HSL supplementation significantly attenuated fat mass gain (from 98 g to 75 g) and adiposity indices (10.23 to 8.86) in obese rats without altering total body mass. Moreover, the HSL extract improved lipid profiles by reducing LDL cholesterol from 23 to 13 mg dL−1 and exhibited potential hepatoprotective effects linked with decreased ALT (40 to 26.7 U L−1) and total bilirubin (0.12 to 0.07 mg dL−1) levels. Although glucose metabolism parameters had no significant differences, a trend toward improved insulin sensitivity was observed. These results suggest that the aqueous HSL extract may exert cardioprotective, hepatoprotective, and anti-obesity effects, supporting its potential as a complementary therapeutic agent in obesity and related metabolic disorders. 2025-09-25 Obesities, Vol. 5, Pages 67: Supplementation Effects of Hibiscus sabdariffa L. Flower Aqueous Extract on Body Composition and Metabolism in Eutrophic and Obese Rats

Obesities doi: 10.3390/obesities5040067

Authors: João Fernando Bernardo da Costa Alana Louzada Millions Monteiro Bruna Almeida Nascimento Clarice Maia Vinagre de Oliveira Karen Pereira Coutinho Anderson Junger Teodoro Barbara Elisabeth Teixeira-Costa Mariana Sarto Figueiredo

Obesity is a chronic, multifactorial disease characterized by excess body fat and is a major risk factor for various metabolic disorders. Bioactive compounds from the diet have been recognized for their role in preventing chronic non-communicable diseases and as adjuvants in managing endocrine–metabolic dysfunctions. Hibiscus sabdariffa L. (HSL) is rich in bioactive compounds with antioxidant, antihypertensive, and antihyperlipidemic properties. This study evaluated the effects of HSL flower extract supplementation on body composition, lipid profile, and biochemical parameters in both eutrophic and high-fat diet-induced obese rats. Thirty-two Wistar rats were assigned to four groups: control, control plus HSL extract, high-fat diet, and high-fat diet plus HSL extract. The extract was administered orally at 150 mg kg−1 for thirty days. Dual-energy X-ray absorptiometry revealed that HSL supplementation significantly attenuated fat mass gain (from 98 g to 75 g) and adiposity indices (10.23 to 8.86) in obese rats without altering total body mass. Moreover, the HSL extract improved lipid profiles by reducing LDL cholesterol from 23 to 13 mg dL−1 and exhibited potential hepatoprotective effects linked with decreased ALT (40 to 26.7 U L−1) and total bilirubin (0.12 to 0.07 mg dL−1) levels. Although glucose metabolism parameters had no significant differences, a trend toward improved insulin sensitivity was observed. These results suggest that the aqueous HSL extract may exert cardioprotective, hepatoprotective, and anti-obesity effects, supporting its potential as a complementary therapeutic agent in obesity and related metabolic disorders.

]]> Supplementation Effects of Hibiscus sabdariffa L. Flower Aqueous Extract on Body Composition and Metabolism in Eutrophic and Obese Rats João Fernando Bernardo da Costa Alana Louzada Millions Monteiro Bruna Almeida Nascimento Clarice Maia Vinagre de Oliveira Karen Pereira Coutinho Anderson Junger Teodoro Barbara Elisabeth Teixeira-Costa Mariana Sarto Figueiredo doi: 10.3390/obesities5040067 Obesities 2025-09-25 Obesities 2025-09-25 5 4 Article 67 10.3390/obesities5040067 https://www.mdpi.com/2673-4168/5/4/67 Obesities, Vol. 5, Pages 66: Cross-European Patterns of Obesity: Where Does Croatia Stand?—Descriptive Analysis of Waves 2015–2022 of the Survey of Health, Ageing and Retirement in Europe (SHARE) Including Adults Aged Over 50 https://www.mdpi.com/2673-4168/5/3/66 This paper investigates the prevalence of obesity and its links to health and dietary habits in middle-aged and older populations in Europe (50+), with a particular focus on Croatia. In Croatia, only 33.9% of adults have a normal BMI, while almost two-thirds (64.8%) are classified as overweight or obese, placing Croatia among the EU countries with the highest prevalence of overweight. Obesity significantly increases the risk of serious health complications, including cardiovascular disease (CVD) and type 2 diabetes. Therefore, we used data from the SHARE (Survey of Health, Ageing and Retirement in Europe), for the last four waves (wave 6–wave 9). The nutritional status was investigated (using the body mass index, BMI) as well as its relationship with cardiovascular disease and dietary habits. Different BMI categorizations were used (i) for the population under and (ii) over 65 years of age, and the results show that a significant proportion of the middle-aged and older European population is overweight or obese. When it comes to dietary habits, statistically significant differences in meat, fish, or chicken consumption were noted (p < 0.001): the Croatian population, especially men, consumes them significantly more often on a daily basis compared to the EU average. Similar patterns of dairy, legumes/eggs, and fruit/vegetable consumption were observed between the EU and Croatia, although there are some statistically significant differences in daily dairy consumption among the older population and in consumption of legumes/eggs and fruit/vegetables 3–6 times a week among the older population. The prevalence of CVD generally increases with increasing BMI in both regions and age groups. However, Croatia has a statistically significantly lower prevalence of high cholesterol compared to the EU in both age groups. Also, the trend of diabetes is more pronounced in the middle-aged population in Croatia compared to the EU. These results indicate specific differences in dietary habits and the association of BMI with certain CVDs in Croatia compared to the European Union average. 2025-09-18 Obesities, Vol. 5, Pages 66: Cross-European Patterns of Obesity: Where Does Croatia Stand?—Descriptive Analysis of Waves 2015–2022 of the Survey of Health, Ageing and Retirement in Europe (SHARE) Including Adults Aged Over 50

Obesities doi: 10.3390/obesities5030066

Authors: Manuela Maltarić Mirela Kolak Branko Kolarić Darija Vranešić Bender Jasenka Gajdoš Kljusurić

This paper investigates the prevalence of obesity and its links to health and dietary habits in middle-aged and older populations in Europe (50+), with a particular focus on Croatia. In Croatia, only 33.9% of adults have a normal BMI, while almost two-thirds (64.8%) are classified as overweight or obese, placing Croatia among the EU countries with the highest prevalence of overweight. Obesity significantly increases the risk of serious health complications, including cardiovascular disease (CVD) and type 2 diabetes. Therefore, we used data from the SHARE (Survey of Health, Ageing and Retirement in Europe), for the last four waves (wave 6–wave 9). The nutritional status was investigated (using the body mass index, BMI) as well as its relationship with cardiovascular disease and dietary habits. Different BMI categorizations were used (i) for the population under and (ii) over 65 years of age, and the results show that a significant proportion of the middle-aged and older European population is overweight or obese. When it comes to dietary habits, statistically significant differences in meat, fish, or chicken consumption were noted (p < 0.001): the Croatian population, especially men, consumes them significantly more often on a daily basis compared to the EU average. Similar patterns of dairy, legumes/eggs, and fruit/vegetable consumption were observed between the EU and Croatia, although there are some statistically significant differences in daily dairy consumption among the older population and in consumption of legumes/eggs and fruit/vegetables 3–6 times a week among the older population. The prevalence of CVD generally increases with increasing BMI in both regions and age groups. However, Croatia has a statistically significantly lower prevalence of high cholesterol compared to the EU in both age groups. Also, the trend of diabetes is more pronounced in the middle-aged population in Croatia compared to the EU. These results indicate specific differences in dietary habits and the association of BMI with certain CVDs in Croatia compared to the European Union average.

]]> Cross-European Patterns of Obesity: Where Does Croatia Stand?—Descriptive Analysis of Waves 2015–2022 of the Survey of Health, Ageing and Retirement in Europe (SHARE) Including Adults Aged Over 50 Manuela Maltarić Mirela Kolak Branko Kolarić Darija Vranešić Bender Jasenka Gajdoš Kljusurić doi: 10.3390/obesities5030066 Obesities 2025-09-18 Obesities 2025-09-18 5 3 Article 66 10.3390/obesities5030066 https://www.mdpi.com/2673-4168/5/3/66 Obesities, Vol. 5, Pages 65: Associations Between Occupational Stress, Disordered Eating, and Obesity Among Police Officers in North Carolina https://www.mdpi.com/2673-4168/5/3/65 Obesity is a major public health concern among police officers, yet the links between occupational stress, disordered eating, and obesity remain unclear. This cross-sectional study examined 496 North Carolina officers to (1) assess severity of occupational stress (posttraumatic stress disorder [PTSD] symptoms, anti-police sentiment, fear of victimization), disordered eating (binge eating and loss-of-control eating), and obesity by county type, region, and sex; (2) evaluate associations between occupational stress and disordered eating; and (3) explore relationships between disordered eating and weight-related measures. Officers completed online surveys, and trained staff measured body mass index (BMI), waist and hip circumferences, and waist-to-hip ratio. Nearly 60 percent of officers were classified as obese (BMI ≥ 30 kg/m2), and over 20 percent reported moderate to severe binge eating. Rural officers reported higher PTSD symptoms, binge eating, and loss-of-control eating than those in urban or suburban areas. Coastal Plain and Piedmont officers had higher BMI and larger waist and hip circumferences than those in the Mountain region. Higher occupational stress was linked to more severe disordered eating, which was associated with greater BMI and adiposity, although the effect sizes were modest. Findings support targeted interventions addressing occupational stress and disordered eating to prevent obesity and enhance officer well-being. 2025-09-15 Obesities, Vol. 5, Pages 65: Associations Between Occupational Stress, Disordered Eating, and Obesity Among Police Officers in North Carolina

Obesities doi: 10.3390/obesities5030065

Authors: Ya-Ke Wu Hanxin Liu

Obesity is a major public health concern among police officers, yet the links between occupational stress, disordered eating, and obesity remain unclear. This cross-sectional study examined 496 North Carolina officers to (1) assess severity of occupational stress (posttraumatic stress disorder [PTSD] symptoms, anti-police sentiment, fear of victimization), disordered eating (binge eating and loss-of-control eating), and obesity by county type, region, and sex; (2) evaluate associations between occupational stress and disordered eating; and (3) explore relationships between disordered eating and weight-related measures. Officers completed online surveys, and trained staff measured body mass index (BMI), waist and hip circumferences, and waist-to-hip ratio. Nearly 60 percent of officers were classified as obese (BMI ≥ 30 kg/m2), and over 20 percent reported moderate to severe binge eating. Rural officers reported higher PTSD symptoms, binge eating, and loss-of-control eating than those in urban or suburban areas. Coastal Plain and Piedmont officers had higher BMI and larger waist and hip circumferences than those in the Mountain region. Higher occupational stress was linked to more severe disordered eating, which was associated with greater BMI and adiposity, although the effect sizes were modest. Findings support targeted interventions addressing occupational stress and disordered eating to prevent obesity and enhance officer well-being.

]]> Associations Between Occupational Stress, Disordered Eating, and Obesity Among Police Officers in North Carolina Ya-Ke Wu Hanxin Liu doi: 10.3390/obesities5030065 Obesities 2025-09-15 Obesities 2025-09-15 5 3 Article 65 10.3390/obesities5030065 https://www.mdpi.com/2673-4168/5/3/65 Obesities, Vol. 5, Pages 64: Obesity–Housing Nexus: An Integrative Conceptualization of the Impact of Housing and Built Environment on Obesity https://www.mdpi.com/2673-4168/5/3/64 Obesity has emerged as one of the most significant public health challenges of the 21st century, with its prevalence increasing at an alarming rate globally. While individual factors such as diet and physical inactivity are well-known contributors, the built environment, particularly housing, plays a critical yet understudied role in shaping obesity-related behaviors. This study examines the multilayered relationship between housing and obesity, focusing on built and neighborhood environment, affordability, and the social environment. Poor housing quality, such as overcrowding and inadequate ventilation, can potentially lead to chronic stress and sedentary behaviors, while housing design influences physical activity through characteristics such as design features and outdoor spaces. Housing location affects access to amenities such as parks and healthy food options, with disparities in access contributing to obesity in low-income areas. Similarly, neighborhood walkability, influenced by infrastructure and land use, encourages active transportation and recreation. Housing affordability also impacts dietary choices and access to recreational facilities, particularly for low-income families. Moreover, the social environment within housing communities can foster or hinder healthy behaviors through social networks and community engagement. This study emphasizes the need for health-conscious urban planning and policies that address these housing-related factors to combat obesity and promote healthier lifestyles. By integrating these Obesity–Housing Nexus, policymakers can create environments that support physical activity, healthy eating, as well as overall health and well-being. 2025-08-20 Obesities, Vol. 5, Pages 64: Obesity–Housing Nexus: An Integrative Conceptualization of the Impact of Housing and Built Environment on Obesity

Obesities doi: 10.3390/obesities5030064

Authors: Kritika Rana Ritesh Chimoriya

Obesity has emerged as one of the most significant public health challenges of the 21st century, with its prevalence increasing at an alarming rate globally. While individual factors such as diet and physical inactivity are well-known contributors, the built environment, particularly housing, plays a critical yet understudied role in shaping obesity-related behaviors. This study examines the multilayered relationship between housing and obesity, focusing on built and neighborhood environment, affordability, and the social environment. Poor housing quality, such as overcrowding and inadequate ventilation, can potentially lead to chronic stress and sedentary behaviors, while housing design influences physical activity through characteristics such as design features and outdoor spaces. Housing location affects access to amenities such as parks and healthy food options, with disparities in access contributing to obesity in low-income areas. Similarly, neighborhood walkability, influenced by infrastructure and land use, encourages active transportation and recreation. Housing affordability also impacts dietary choices and access to recreational facilities, particularly for low-income families. Moreover, the social environment within housing communities can foster or hinder healthy behaviors through social networks and community engagement. This study emphasizes the need for health-conscious urban planning and policies that address these housing-related factors to combat obesity and promote healthier lifestyles. By integrating these Obesity–Housing Nexus, policymakers can create environments that support physical activity, healthy eating, as well as overall health and well-being.

]]> Obesity–Housing Nexus: An Integrative Conceptualization of the Impact of Housing and Built Environment on Obesity Kritika Rana Ritesh Chimoriya doi: 10.3390/obesities5030064 Obesities 2025-08-20 Obesities 2025-08-20 5 3 Review 64 10.3390/obesities5030064 https://www.mdpi.com/2673-4168/5/3/64 Obesities, Vol. 5, Pages 63: “Super-Responders” to Liraglutide Monotherapy and the Growing Evidence of Efficacy of GLP-1 Analogues in Obesity Management: A Longitudinal Prospective Cohort Study https://www.mdpi.com/2673-4168/5/3/63 Aims: Individual weight loss results achieved with Glucagon-like Peptide-1 receptor agonists (GLP-1RA) vary significantly. Our aim was to describe the characteristics of patients with obesity who achieved ≥ 20% total weight loss (TWL) on liraglutide and appraise those findings through the prism of an evolving spectrum of GLP-1RA. Methods: This longitudinal prospective cohort study included 21 patients (90.5% females, age 50 (IQR 17) years, class II/III obesity (Body Mass Index ≥ 35 kg/m2) followed at the Edmonton Adult Bariatric Clinic for 65.1 (IQR 15.5) weeks. All patients received treatment with liraglutide 3.0 mg subcutaneously daily along with involvement in an integrated lifestyle modification program. Results: Liraglutide was well-tolerated, with its benefits experienced by >90% of patients. The vast majority were consistently tracking calories (95.2%, n = 20) and protein intake (90.5%, n = 19), achieving a calorie deficit of 651 (IQR 323) kcal/day, and had their mental health conditions and psychological issues successfully managed. At 16, 26, and 52 weeks, TWL was 14.3% (IQR 3.7), 18.7% (IQR 8.8), and 25.9% (IQR 9.6), respectively (p < 0.001). Over 20% TWL was achieved by 72.2% of patients by week 52. Conclusions: A select number of patients with obesity will attain weight loss that rivals bariatric surgery using liraglutide monotherapy. Despite liraglutide being less effective compared to newer agents on the market, some individuals will respond strongly and should be considered when other therapies are inaccessible. Given the societal burden and numerous challenges faced by people with obesity, GLP-1RA should be pursued in clinical practice to assist in achieving weight loss goals while being convenient and safe. 2025-08-20 Obesities, Vol. 5, Pages 63: “Super-Responders” to Liraglutide Monotherapy and the Growing Evidence of Efficacy of GLP-1 Analogues in Obesity Management: A Longitudinal Prospective Cohort Study

Obesities doi: 10.3390/obesities5030063

Authors: Ellina Lytvyak Eduardo Grunvald Devika Shreekumar Peter Rye Olexandr Troshyn Sarah Cawsey Aldo J. Montano-Loza Arya M. Sharma Renuca Modi

Aims: Individual weight loss results achieved with Glucagon-like Peptide-1 receptor agonists (GLP-1RA) vary significantly. Our aim was to describe the characteristics of patients with obesity who achieved ≥ 20% total weight loss (TWL) on liraglutide and appraise those findings through the prism of an evolving spectrum of GLP-1RA. Methods: This longitudinal prospective cohort study included 21 patients (90.5% females, age 50 (IQR 17) years, class II/III obesity (Body Mass Index ≥ 35 kg/m2) followed at the Edmonton Adult Bariatric Clinic for 65.1 (IQR 15.5) weeks. All patients received treatment with liraglutide 3.0 mg subcutaneously daily along with involvement in an integrated lifestyle modification program. Results: Liraglutide was well-tolerated, with its benefits experienced by >90% of patients. The vast majority were consistently tracking calories (95.2%, n = 20) and protein intake (90.5%, n = 19), achieving a calorie deficit of 651 (IQR 323) kcal/day, and had their mental health conditions and psychological issues successfully managed. At 16, 26, and 52 weeks, TWL was 14.3% (IQR 3.7), 18.7% (IQR 8.8), and 25.9% (IQR 9.6), respectively (p < 0.001). Over 20% TWL was achieved by 72.2% of patients by week 52. Conclusions: A select number of patients with obesity will attain weight loss that rivals bariatric surgery using liraglutide monotherapy. Despite liraglutide being less effective compared to newer agents on the market, some individuals will respond strongly and should be considered when other therapies are inaccessible. Given the societal burden and numerous challenges faced by people with obesity, GLP-1RA should be pursued in clinical practice to assist in achieving weight loss goals while being convenient and safe.

]]> “Super-Responders” to Liraglutide Monotherapy and the Growing Evidence of Efficacy of GLP-1 Analogues in Obesity Management: A Longitudinal Prospective Cohort Study Ellina Lytvyak Eduardo Grunvald Devika Shreekumar Peter Rye Olexandr Troshyn Sarah Cawsey Aldo J. Montano-Loza Arya M. Sharma Renuca Modi doi: 10.3390/obesities5030063 Obesities 2025-08-20 Obesities 2025-08-20 5 3 Article 63 10.3390/obesities5030063 https://www.mdpi.com/2673-4168/5/3/63 Obesities, Vol. 5, Pages 62: Adherence to the Mediterranean Diet and Carotid Intima-Media Thickness in University Students: A Cross-Sectional Study https://www.mdpi.com/2673-4168/5/3/62 Introduction: Subclinical atherosclerosis is increasingly recognized in younger populations, often progressing silently until the onset of overt cardiovascular events. Carotid intima-media thickness (CIMT) is a validated, non-invasive biomarker of early vascular alterations. Although the Mediterranean diet (MD) is well established as cardioprotective, its relationship with CIMT in young adults remains insufficiently studied. Objective: To assess sex-specific adherence to the Mediterranean diet and its association with carotid intima-media thickness in a cohort of university students. Methods: A cross-sectional study was performed involving 60 university students (50% male, aged 17–25 years), selected through stratified probabilistic sampling. Data were collected on sociodemographic characteristics, vascular risk factors, MD adherence via the PREDIMED questionnaire, and CIMT measured using a high-resolution carotid Doppler ultrasound. Statistical analyses included chi-square tests and descriptive statistics, with significance set at ρ ≤ 0.05. Results: A notable 95% of participants showed low adherence to the Mediterranean diet. Significant sex differences in dietary patterns were identified: males consumed more red meat (ρ = 0.023), while females reported higher fish intake (ρ = 0.037). Despite behavioral risk factors, all CIMT values remained within normal ranges (≤0.9 mm). No significant association was found between MD adherence and CIMT (ρ = 0.554). Conclusion: This exploratory study reveals a high prevalence of modifiable cardiovascular risk factors, including poor dietary adherence, among young adults, despite the absence of detectable vascular structural changes. Although no significant association was found, the findings reflect the dietary and behavioral profiles of a young, low-risk population. 2025-08-18 Obesities, Vol. 5, Pages 62: Adherence to the Mediterranean Diet and Carotid Intima-Media Thickness in University Students: A Cross-Sectional Study

Obesities doi: 10.3390/obesities5030062

Authors: Sónia Mateus Ana Miguel Amaral Patrícia Coelho Francisco Rodrigues

Introduction: Subclinical atherosclerosis is increasingly recognized in younger populations, often progressing silently until the onset of overt cardiovascular events. Carotid intima-media thickness (CIMT) is a validated, non-invasive biomarker of early vascular alterations. Although the Mediterranean diet (MD) is well established as cardioprotective, its relationship with CIMT in young adults remains insufficiently studied. Objective: To assess sex-specific adherence to the Mediterranean diet and its association with carotid intima-media thickness in a cohort of university students. Methods: A cross-sectional study was performed involving 60 university students (50% male, aged 17–25 years), selected through stratified probabilistic sampling. Data were collected on sociodemographic characteristics, vascular risk factors, MD adherence via the PREDIMED questionnaire, and CIMT measured using a high-resolution carotid Doppler ultrasound. Statistical analyses included chi-square tests and descriptive statistics, with significance set at ρ ≤ 0.05. Results: A notable 95% of participants showed low adherence to the Mediterranean diet. Significant sex differences in dietary patterns were identified: males consumed more red meat (ρ = 0.023), while females reported higher fish intake (ρ = 0.037). Despite behavioral risk factors, all CIMT values remained within normal ranges (≤0.9 mm). No significant association was found between MD adherence and CIMT (ρ = 0.554). Conclusion: This exploratory study reveals a high prevalence of modifiable cardiovascular risk factors, including poor dietary adherence, among young adults, despite the absence of detectable vascular structural changes. Although no significant association was found, the findings reflect the dietary and behavioral profiles of a young, low-risk population.

]]> Adherence to the Mediterranean Diet and Carotid Intima-Media Thickness in University Students: A Cross-Sectional Study Sónia Mateus Ana Miguel Amaral Patrícia Coelho Francisco Rodrigues doi: 10.3390/obesities5030062 Obesities 2025-08-18 Obesities 2025-08-18 5 3 Article 62 10.3390/obesities5030062 https://www.mdpi.com/2673-4168/5/3/62 Obesities, Vol. 5, Pages 61: Phase Angle Is Related with Visceral Obesity in Young Adults https://www.mdpi.com/2673-4168/5/3/61 Obesity is a global problem, increasing interest in adipose tissue (AT) biology. One of the techniques for analyzing visceral adipose tissue (VAT) and phase angle (PhA) is bioelectrical impedance analysis (BIA). PhA is considered an indicator of cell integrity and health and can be a prognostic marker in diseases and clinical conditions. The aim of the study was to assess the nutritional status and level of visceral fat area (VFA) to investigate the association between phase angle (PhA) and content of visceral adipose tissue in young adults. Our cohort consisted of 292 young adults (18–25), both sexes. Body composition was performed by the inBody 770 analyzer. We confirmed the relationship between PhA and gender (female vs. male: 5.3 vs. 6.5; p < 0.001) and BMI (female vs. male: 22.56 kg/m2 vs. 23.78 kg/m2; p = 0.013). A total of 20.2% of examined students had a VFA of more than 100 cm2 (Visceral Obesity, VO). We demonstrated a dependence between VFA and PhA value (PhA = 5.4 (VFA > 100 cm2) vs. PhA = 5.7 (VFA < 100 cm2), p = 0.003). Students with VO and normal BMI had a significantly lower PhA than those with VO and BMI ≥ 30 kg/m2 (p = 0.021). PhA may be a useful indicator for assessing nutritional status and physiological differences related to gender, BMI, and visceral obesity in young adults. 2025-08-15 Obesities, Vol. 5, Pages 61: Phase Angle Is Related with Visceral Obesity in Young Adults

Obesities doi: 10.3390/obesities5030061

Authors: Izabela Mandryk Joanna Bonior Magdalena Koszarska

Obesity is a global problem, increasing interest in adipose tissue (AT) biology. One of the techniques for analyzing visceral adipose tissue (VAT) and phase angle (PhA) is bioelectrical impedance analysis (BIA). PhA is considered an indicator of cell integrity and health and can be a prognostic marker in diseases and clinical conditions. The aim of the study was to assess the nutritional status and level of visceral fat area (VFA) to investigate the association between phase angle (PhA) and content of visceral adipose tissue in young adults. Our cohort consisted of 292 young adults (18–25), both sexes. Body composition was performed by the inBody 770 analyzer. We confirmed the relationship between PhA and gender (female vs. male: 5.3 vs. 6.5; p < 0.001) and BMI (female vs. male: 22.56 kg/m2 vs. 23.78 kg/m2; p = 0.013). A total of 20.2% of examined students had a VFA of more than 100 cm2 (Visceral Obesity, VO). We demonstrated a dependence between VFA and PhA value (PhA = 5.4 (VFA > 100 cm2) vs. PhA = 5.7 (VFA < 100 cm2), p = 0.003). Students with VO and normal BMI had a significantly lower PhA than those with VO and BMI ≥ 30 kg/m2 (p = 0.021). PhA may be a useful indicator for assessing nutritional status and physiological differences related to gender, BMI, and visceral obesity in young adults.

]]> Phase Angle Is Related with Visceral Obesity in Young Adults Izabela Mandryk Joanna Bonior Magdalena Koszarska doi: 10.3390/obesities5030061 Obesities 2025-08-15 Obesities 2025-08-15 5 3 Article 61 10.3390/obesities5030061 https://www.mdpi.com/2673-4168/5/3/61 Obesities, Vol. 5, Pages 60: Associations Between Self-Perceived Psychosocial Stress and Markers of Adiposity in Ga Mashie, Urban Ghana: Evidence from a Cross-Sectional Population-Based Survey https://www.mdpi.com/2673-4168/5/3/60 Prior research from Ghana suggests psychosocial stress is associated with lower body mass index (BMI) and waist circumference (WC), both markers of adiposity, contrasting with meta-analyses showing positive associations in other settings. This study aimed to explore how stress was associated with markers of adiposity in urban Ghanaian adults. Data included 854 adults from the Contextual Awareness, Response and Evaluation Diabetes in Ghana survey carried out in November–December 2022 in Ga Mashie, a deprived area of the capital Accra. Associations between self-perceived stress (Perceived Stress Scale 10, categorized into low and average–high stress) and BMI or WC-for-height ratio (WHR) were assessed using linear regression. Results were adjusted for survey design and confounders and stratified by sex. Greater stress was associated with higher BMI and WHR in females (adjusted coeff. [95% CI]: BMI: 2.3 [0.5, 4.0], WHR: 0.03 [0.00, 0.06]). No associations were found in males. These findings highlight the need to understand the complex interactions between gender, stress, and increasing burdens of obesity and other associated non-communicable diseases in urban African settings, with a view to designing context-specific interventions to reduce risk. 2025-08-09 Obesities, Vol. 5, Pages 60: Associations Between Self-Perceived Psychosocial Stress and Markers of Adiposity in Ga Mashie, Urban Ghana: Evidence from a Cross-Sectional Population-Based Survey

Obesities doi: 10.3390/obesities5030060

Authors: Emeline Rougeaux Samuel Amon Leonard Baatiema Sandra Boatemaa Kushitor Mawuli Komla Kushitor Sedzro Kojo Mensah Rolando Leiva-Granados Akanksha A. Marphatia Jonathan C. K. Wells Carlos Salvador Grijalva-Eternod Irene Akwo Kretchy Edward Fottrell

Prior research from Ghana suggests psychosocial stress is associated with lower body mass index (BMI) and waist circumference (WC), both markers of adiposity, contrasting with meta-analyses showing positive associations in other settings. This study aimed to explore how stress was associated with markers of adiposity in urban Ghanaian adults. Data included 854 adults from the Contextual Awareness, Response and Evaluation Diabetes in Ghana survey carried out in November–December 2022 in Ga Mashie, a deprived area of the capital Accra. Associations between self-perceived stress (Perceived Stress Scale 10, categorized into low and average–high stress) and BMI or WC-for-height ratio (WHR) were assessed using linear regression. Results were adjusted for survey design and confounders and stratified by sex. Greater stress was associated with higher BMI and WHR in females (adjusted coeff. [95% CI]: BMI: 2.3 [0.5, 4.0], WHR: 0.03 [0.00, 0.06]). No associations were found in males. These findings highlight the need to understand the complex interactions between gender, stress, and increasing burdens of obesity and other associated non-communicable diseases in urban African settings, with a view to designing context-specific interventions to reduce risk.

]]> Associations Between Self-Perceived Psychosocial Stress and Markers of Adiposity in Ga Mashie, Urban Ghana: Evidence from a Cross-Sectional Population-Based Survey Emeline Rougeaux Samuel Amon Leonard Baatiema Sandra Boatemaa Kushitor Mawuli Komla Kushitor Sedzro Kojo Mensah Rolando Leiva-Granados Akanksha A. Marphatia Jonathan C. K. Wells Carlos Salvador Grijalva-Eternod Irene Akwo Kretchy Edward Fottrell doi: 10.3390/obesities5030060 Obesities 2025-08-09 Obesities 2025-08-09 5 3 Article 60 10.3390/obesities5030060 https://www.mdpi.com/2673-4168/5/3/60 Obesities, Vol. 5, Pages 59: Resetting Time: The Role of Exercise Timing in Circadian Reprogramming for Metabolic Health https://www.mdpi.com/2673-4168/5/3/59 Circadian rhythms are intrinsic 24 h cycles that regulate metabolic processes across multiple tissues, with skeletal muscle emerging as a central node in this temporal network. Muscle clocks govern gene expression, fuel utilisation, mitochondrial function, and insulin sensitivity, thereby maintaining systemic energy homeostasis. However, circadian misalignment, whether due to behavioural disruption, nutrient excess, or metabolic disease, impairs these rhythms and contributes to insulin resistance, and the development of obesity, and type 2 diabetes mellitus. Notably, the muscle clock remains responsive to non-photic cues, particularly exercise, which can reset and amplify circadian rhythms even in metabolically impaired states. This work synthesises multi-level evidence from rodent models, human trials, and in vitro studies to elucidate the role of skeletal muscle clocks in circadian metabolic health. It explores how exercise entrains the muscle clock via molecular pathways involving AMPK, SIRT1, and PGC-1α, and highlights the time-of-day dependency of these effects. Emerging data demonstrate that optimally timed exercise enhances glucose uptake, mitochondrial biogenesis, and circadian gene expression more effectively than time-agnostic training, especially in individuals with metabolic dysfunction. Finally, findings are integrated from multi-omic approaches that have uncovered dynamic, time-dependent molecular signatures that underpin circadian regulation and its disruption in obesity. These technologies are uncovering biomarkers and signalling nodes that may inform personalised, temporally targeted interventions. By combining mechanistic insights with translational implications, this review positions skeletal muscle clocks as both regulators and therapeutic targets in metabolic disease. It offers a conceptual framework for chrono-exercise strategies and highlights the promise of multi-omics in developing precision chrono-medicine approaches aimed at restoring circadian alignment and improving metabolic health outcomes. 2025-08-07 Obesities, Vol. 5, Pages 59: Resetting Time: The Role of Exercise Timing in Circadian Reprogramming for Metabolic Health

Obesities doi: 10.3390/obesities5030059

Authors: Stuart J. Hesketh

Circadian rhythms are intrinsic 24 h cycles that regulate metabolic processes across multiple tissues, with skeletal muscle emerging as a central node in this temporal network. Muscle clocks govern gene expression, fuel utilisation, mitochondrial function, and insulin sensitivity, thereby maintaining systemic energy homeostasis. However, circadian misalignment, whether due to behavioural disruption, nutrient excess, or metabolic disease, impairs these rhythms and contributes to insulin resistance, and the development of obesity, and type 2 diabetes mellitus. Notably, the muscle clock remains responsive to non-photic cues, particularly exercise, which can reset and amplify circadian rhythms even in metabolically impaired states. This work synthesises multi-level evidence from rodent models, human trials, and in vitro studies to elucidate the role of skeletal muscle clocks in circadian metabolic health. It explores how exercise entrains the muscle clock via molecular pathways involving AMPK, SIRT1, and PGC-1α, and highlights the time-of-day dependency of these effects. Emerging data demonstrate that optimally timed exercise enhances glucose uptake, mitochondrial biogenesis, and circadian gene expression more effectively than time-agnostic training, especially in individuals with metabolic dysfunction. Finally, findings are integrated from multi-omic approaches that have uncovered dynamic, time-dependent molecular signatures that underpin circadian regulation and its disruption in obesity. These technologies are uncovering biomarkers and signalling nodes that may inform personalised, temporally targeted interventions. By combining mechanistic insights with translational implications, this review positions skeletal muscle clocks as both regulators and therapeutic targets in metabolic disease. It offers a conceptual framework for chrono-exercise strategies and highlights the promise of multi-omics in developing precision chrono-medicine approaches aimed at restoring circadian alignment and improving metabolic health outcomes.

]]> Resetting Time: The Role of Exercise Timing in Circadian Reprogramming for Metabolic Health Stuart J. Hesketh doi: 10.3390/obesities5030059 Obesities 2025-08-07 Obesities 2025-08-07 5 3 Review 59 10.3390/obesities5030059 https://www.mdpi.com/2673-4168/5/3/59 Obesities, Vol. 5, Pages 58: Closing the Gap in Behavioral Weight Loss Therapy: Prospective Analysis of Clinical Real-World Data of a Four-Year Health Insurance-Financed Program https://www.mdpi.com/2673-4168/5/3/58 Our four-year interdisciplinary behavioral weight loss program is fully covered by public health insurance for patients with a body mass index of ≥35 kg/m2. We evaluated the real-world outcomes of anthropometric, metabolic and psychologic parameters collected prior to the start (t0, n = 381, 71% women) and after each segment of the program (t1–4, n = 243, 126, 94, and 77). It is a prospective evaluation of clinical real-world data including all patients who started the first segment of behavioral treatment until they quit/finished the program. The mean dropout rates per treatment segment were 23%. Body weight after one year decreased from 127.3 kg to 122.2 (p < 0.001). Average hemoglobin A1c value decreased from 5.8% to 5.6% in all patients (p < 0.001) and from 6.6% to 6.2% in patients with type 2 diabetes (p < 0.001). Further metabolic and psychological parameters improved significantly as well. The average weight nadir was reached after two segments, co-occurring with the most beneficial changes in laboratory parameters. Afterwards, mean weight slightly increased accompanied by a discrete loss of benefits in laboratory parameters. Our real-world data with significant health improvements adds important value to discussions about the funding of obesity therapy and thus has the chance to improve therapy availability for obesity patients worldwide. 2025-07-21 Obesities, Vol. 5, Pages 58: Closing the Gap in Behavioral Weight Loss Therapy: Prospective Analysis of Clinical Real-World Data of a Four-Year Health Insurance-Financed Program

Obesities doi: 10.3390/obesities5030058

Authors: Sarah Victoria Frenzel Hans-Christian Puls Susan Vogl Franziska Frölich Hannes Felten Nicole Schlenz Michael Stumvoll Mathias Fasshauer Matthias Blüher Anja Hilbert Haiko Schlögl

Our four-year interdisciplinary behavioral weight loss program is fully covered by public health insurance for patients with a body mass index of ≥35 kg/m2. We evaluated the real-world outcomes of anthropometric, metabolic and psychologic parameters collected prior to the start (t0, n = 381, 71% women) and after each segment of the program (t1–4, n = 243, 126, 94, and 77). It is a prospective evaluation of clinical real-world data including all patients who started the first segment of behavioral treatment until they quit/finished the program. The mean dropout rates per treatment segment were 23%. Body weight after one year decreased from 127.3 kg to 122.2 (p < 0.001). Average hemoglobin A1c value decreased from 5.8% to 5.6% in all patients (p < 0.001) and from 6.6% to 6.2% in patients with type 2 diabetes (p < 0.001). Further metabolic and psychological parameters improved significantly as well. The average weight nadir was reached after two segments, co-occurring with the most beneficial changes in laboratory parameters. Afterwards, mean weight slightly increased accompanied by a discrete loss of benefits in laboratory parameters. Our real-world data with significant health improvements adds important value to discussions about the funding of obesity therapy and thus has the chance to improve therapy availability for obesity patients worldwide.

]]> Closing the Gap in Behavioral Weight Loss Therapy: Prospective Analysis of Clinical Real-World Data of a Four-Year Health Insurance-Financed Program Sarah Victoria Frenzel Hans-Christian Puls Susan Vogl Franziska Frölich Hannes Felten Nicole Schlenz Michael Stumvoll Mathias Fasshauer Matthias Blüher Anja Hilbert Haiko Schlögl doi: 10.3390/obesities5030058 Obesities 2025-07-21 Obesities 2025-07-21 5 3 Article 58 10.3390/obesities5030058 https://www.mdpi.com/2673-4168/5/3/58 Obesities, Vol. 5, Pages 57: A Combination of Insufficient Physical Activity and Sedentary Behavior Associated with Dynapenic Abdominal Obesity and Dynapenic Obesity in Older Adults: A Cross-Sectional Analysis https://www.mdpi.com/2673-4168/5/3/57 Objective: To investigate the association between combined physical activity (PA) levels and sedentary behavior (SB) with dynapenic abdominal obesity (DAO) and dynapenic obesity (DO) in older adults. Methods: This cross-sectional, population-based epidemiological study included 207 community-dwelling older adults (58.90% women). PA and SB were assessed using the International Physical Activity Questionnaire. Participants were categorized into four groups: (G1) sufficiently active and low SB; (G2) sufficiently active and high SB; (G3) insufficiently active and low SB; and (G4) insufficiently active and high SB. DAO and DO were defined as the coexistence of dynapenia with abdominal and general obesity, respectively. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. Results: The prevalence of DAO was 11.10% and DO was 6.80%. In the adjusted analysis, participants classified as insufficiently active with high SB (G4) had 5.54 times the prevalence of DAO (PR: 5.54, 95% CI: 1.91–16.03) and 6.54 times the prevalence of DO (PR: 6.54, 95% CI: 1.68–36.66) compared to the reference group (G1) (sufficiently active and low SB). Conclusions: Insufficient PA combined with high SB was positively associated with both DAO and DO in the studied population of older adults. 2025-07-18 Obesities, Vol. 5, Pages 57: A Combination of Insufficient Physical Activity and Sedentary Behavior Associated with Dynapenic Abdominal Obesity and Dynapenic Obesity in Older Adults: A Cross-Sectional Analysis

Obesities doi: 10.3390/obesities5030057

Authors: Lucas dos Santos Paulo da Fonseca Valença Neto Claudio Bispo de Almeida Raildo da Silva Coqueiro Douglas de Assis Teles Santos José Ailton Oliveira Carneiro Pabline dos Santos Santana Elayny Lopes Costa Lucas Lima Galvão Cezar Augusto Casotti

Objective: To investigate the association between combined physical activity (PA) levels and sedentary behavior (SB) with dynapenic abdominal obesity (DAO) and dynapenic obesity (DO) in older adults. Methods: This cross-sectional, population-based epidemiological study included 207 community-dwelling older adults (58.90% women). PA and SB were assessed using the International Physical Activity Questionnaire. Participants were categorized into four groups: (G1) sufficiently active and low SB; (G2) sufficiently active and high SB; (G3) insufficiently active and low SB; and (G4) insufficiently active and high SB. DAO and DO were defined as the coexistence of dynapenia with abdominal and general obesity, respectively. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated using Poisson regression with robust variance. Results: The prevalence of DAO was 11.10% and DO was 6.80%. In the adjusted analysis, participants classified as insufficiently active with high SB (G4) had 5.54 times the prevalence of DAO (PR: 5.54, 95% CI: 1.91–16.03) and 6.54 times the prevalence of DO (PR: 6.54, 95% CI: 1.68–36.66) compared to the reference group (G1) (sufficiently active and low SB). Conclusions: Insufficient PA combined with high SB was positively associated with both DAO and DO in the studied population of older adults.

]]> A Combination of Insufficient Physical Activity and Sedentary Behavior Associated with Dynapenic Abdominal Obesity and Dynapenic Obesity in Older Adults: A Cross-Sectional Analysis Lucas dos Santos Paulo da Fonseca Valença Neto Claudio Bispo de Almeida Raildo da Silva Coqueiro Douglas de Assis Teles Santos José Ailton Oliveira Carneiro Pabline dos Santos Santana Elayny Lopes Costa Lucas Lima Galvão Cezar Augusto Casotti doi: 10.3390/obesities5030057 Obesities 2025-07-18 Obesities 2025-07-18 5 3 Article 57 10.3390/obesities5030057 https://www.mdpi.com/2673-4168/5/3/57 Obesities, Vol. 5, Pages 56: Diet Therapy Improves Body Composition, Blood Pressure and Glycemic Status in Individuals Living with Type 2 Diabetes: A Prospective Cohort Study https://www.mdpi.com/2673-4168/5/3/56 Westernization of traditional diets has been implicated in the rising burden of overweight/obesity and type 2 diabetes, especially in developing countries. In recent times, diet therapy is increasingly being recognized as an essential component of diabetes care. This study assessed the effect of diet therapy on body composition, antioxidant nutrient intake, and glycemic status in individuals living with type 2 diabetes (ILWT2D). In this prospective observational cohort study, 45 ILWT2D who were receiving diet therapy (personalized dietary counseling) in addition to standard medical treatment (intervention group) were compared with 45 ILWT2D receiving only standard medical treatment (comparator group). Antioxidant micronutrient intake was assessed using a 24-h dietary recall. Body composition indices, including body mass index (BMI), percentage body fat (%BF), and visceral fat (VF), were assessed. Participants’ fasting blood glucose (FBG), glycated hemoglobin (HbA1C) levels, and blood pressure (BP) were measured. All measurements were performed before and after a three-month period. There were significant improvements in BMI (27.8 ± 6.0 kg/m2 vs. 26.9 ± 5.5 kg/m2, p = 0.003), %BF (37.8 ± 11.9% vs. 35.5 ± 10.5%, p < 0.001), visceral fat (9.8 ± 3.4 vs. 9.1 ± 3.2, p < 0.001), systolic BP (136.9 ± 19.9 mmHg vs. 124.6 ± 13.0 mmHg, p < 0.001), FBG (8.8 ± 2.8 mmol/L vs. 6.7 ± 1.5 mmol/L, p < 0.001), and HbA1c (7.3 ± 1.0% vs. 6.4 ± 0.8%, p < 0.001) in the intervention group from baseline to endline, but not in the comparator group. In contrast, %BF increased within the comparator group (39.9 ± 7.8 vs. 40.7 ± 7.4; p = 0.029). Vitamin A intake increased significantly (227.5 ± 184.3 µg vs. 318.8 ± 274.7 µg, p = 0.038) within the intervention group but not in the comparator group (174.9 ± 154.3 µg, 193.7 ± 101.4 µg, p = 0.54). There were no significant changes in zinc, copper, selenium, and vitamin C intakes (p > 0.05) in the intervention group from the baseline to endline, unlike those in the comparator group who showed a significant increase in the intake of these nutrients. There was a significant increase in vitamin A intake among the ILWT2D who received dietary counseling as an intervention compared to those who did not. Additionally, the ILWT2D who received dietary counseling had significant improvements in their body composition (BMI, body fat, and visceral fat) and systolic blood pressure, compared to those who did not. The ILWT2D who received the intervention had significantly better glycemic control (FBG and HbA1c) than their counterparts who did not. Thus, this study suggests the potential of diet therapy as a viable non-pharmacological treatment approach for individuals living with type 2 diabetes. 2025-07-17 Obesities, Vol. 5, Pages 56: Diet Therapy Improves Body Composition, Blood Pressure and Glycemic Status in Individuals Living with Type 2 Diabetes: A Prospective Cohort Study

Obesities doi: 10.3390/obesities5030056

Authors: Collins Afriyie Appiah Harriet Wugah Janet Adede Carboo Mary Amoako Michael Akenteng Wiafe Frank Ekow Atta Hayford

Westernization of traditional diets has been implicated in the rising burden of overweight/obesity and type 2 diabetes, especially in developing countries. In recent times, diet therapy is increasingly being recognized as an essential component of diabetes care. This study assessed the effect of diet therapy on body composition, antioxidant nutrient intake, and glycemic status in individuals living with type 2 diabetes (ILWT2D). In this prospective observational cohort study, 45 ILWT2D who were receiving diet therapy (personalized dietary counseling) in addition to standard medical treatment (intervention group) were compared with 45 ILWT2D receiving only standard medical treatment (comparator group). Antioxidant micronutrient intake was assessed using a 24-h dietary recall. Body composition indices, including body mass index (BMI), percentage body fat (%BF), and visceral fat (VF), were assessed. Participants’ fasting blood glucose (FBG), glycated hemoglobin (HbA1C) levels, and blood pressure (BP) were measured. All measurements were performed before and after a three-month period. There were significant improvements in BMI (27.8 ± 6.0 kg/m2 vs. 26.9 ± 5.5 kg/m2, p = 0.003), %BF (37.8 ± 11.9% vs. 35.5 ± 10.5%, p < 0.001), visceral fat (9.8 ± 3.4 vs. 9.1 ± 3.2, p < 0.001), systolic BP (136.9 ± 19.9 mmHg vs. 124.6 ± 13.0 mmHg, p < 0.001), FBG (8.8 ± 2.8 mmol/L vs. 6.7 ± 1.5 mmol/L, p < 0.001), and HbA1c (7.3 ± 1.0% vs. 6.4 ± 0.8%, p < 0.001) in the intervention group from baseline to endline, but not in the comparator group. In contrast, %BF increased within the comparator group (39.9 ± 7.8 vs. 40.7 ± 7.4; p = 0.029). Vitamin A intake increased significantly (227.5 ± 184.3 µg vs. 318.8 ± 274.7 µg, p = 0.038) within the intervention group but not in the comparator group (174.9 ± 154.3 µg, 193.7 ± 101.4 µg, p = 0.54). There were no significant changes in zinc, copper, selenium, and vitamin C intakes (p > 0.05) in the intervention group from the baseline to endline, unlike those in the comparator group who showed a significant increase in the intake of these nutrients. There was a significant increase in vitamin A intake among the ILWT2D who received dietary counseling as an intervention compared to those who did not. Additionally, the ILWT2D who received dietary counseling had significant improvements in their body composition (BMI, body fat, and visceral fat) and systolic blood pressure, compared to those who did not. The ILWT2D who received the intervention had significantly better glycemic control (FBG and HbA1c) than their counterparts who did not. Thus, this study suggests the potential of diet therapy as a viable non-pharmacological treatment approach for individuals living with type 2 diabetes.

]]> Diet Therapy Improves Body Composition, Blood Pressure and Glycemic Status in Individuals Living with Type 2 Diabetes: A Prospective Cohort Study Collins Afriyie Appiah Harriet Wugah Janet Adede Carboo Mary Amoako Michael Akenteng Wiafe Frank Ekow Atta Hayford doi: 10.3390/obesities5030056 Obesities 2025-07-17 Obesities 2025-07-17 5 3 Article 56 10.3390/obesities5030056 https://www.mdpi.com/2673-4168/5/3/56 Obesities, Vol. 5, Pages 55: Cross-Sectional Analysis of Food Group Consumption and Obesity in Children Aged 6–23 Months with Normal and Stunted Growth Patterns in Pakistan https://www.mdpi.com/2673-4168/5/3/55 Background: Worldwide, the awareness about childhood obesity as a public health concern is increasing, particularly in developing countries like Pakistan. Obesity during early childhood may persist into later ages, increasing the risk of chronic illnesses such as diabetes and hypertension. Objective: The aim of this study was to examine the relationship of different types of food groups with obesity among children with normal and stunted growth trajectories in Pakistan. Methods: This cross-sectional study conducted a secondary analysis of Pakistan Demographic and Health Surveys (PDHSs) conducted in the years 2012–2013 and 2017–2018. Data of 1230 healthy and obese children with either normal or stunted growth were analysed after excluding those who were aged below six months, wasted, underweight, or had missing anthropometric or dietary data. The relationship of different food groups with obesity among the children with normal and stunted growth was analysed by bivariate logistic regression. Results: The prevalence of paediatric obesity dropped from 7.3% in 2012–2013 to 2.4% in 2017–2018. However, the coexistence of stunting with obesity—termed the nutritional paradox—slightly increased from 2.8% in 2012–2013 to 3% in 2017–2018. Among the different food groups, the continuation of breastmilk was associated with lowering the odds of obesity by 69% (25% to 88%) among children with normal growth. Conversely, among children with stunted growth, the continuation of breastmilk was associated with an increase in the odds of obesity by 3.71 (1.08 to 12.62) times. Conclusion: Despite the 4.9% reduction in paediatric obesity, cases of the nutritional paradox are still escalating in Pakistan. This reflects an urgent need for targeted nutritional interventions to mitigate the impact of obesogenic diets and reduce the prevalence of childhood obesity in Pakistan. 2025-07-16 Obesities, Vol. 5, Pages 55: Cross-Sectional Analysis of Food Group Consumption and Obesity in Children Aged 6–23 Months with Normal and Stunted Growth Patterns in Pakistan

Obesities doi: 10.3390/obesities5030055

Authors: Asif Khaliq Izzan Ahmed Usmani Yusra Rizwan Mishaim Khan Akif Shahid Khan Noor ul Ain Saleem Muhammad Junaid

Background: Worldwide, the awareness about childhood obesity as a public health concern is increasing, particularly in developing countries like Pakistan. Obesity during early childhood may persist into later ages, increasing the risk of chronic illnesses such as diabetes and hypertension. Objective: The aim of this study was to examine the relationship of different types of food groups with obesity among children with normal and stunted growth trajectories in Pakistan. Methods: This cross-sectional study conducted a secondary analysis of Pakistan Demographic and Health Surveys (PDHSs) conducted in the years 2012–2013 and 2017–2018. Data of 1230 healthy and obese children with either normal or stunted growth were analysed after excluding those who were aged below six months, wasted, underweight, or had missing anthropometric or dietary data. The relationship of different food groups with obesity among the children with normal and stunted growth was analysed by bivariate logistic regression. Results: The prevalence of paediatric obesity dropped from 7.3% in 2012–2013 to 2.4% in 2017–2018. However, the coexistence of stunting with obesity—termed the nutritional paradox—slightly increased from 2.8% in 2012–2013 to 3% in 2017–2018. Among the different food groups, the continuation of breastmilk was associated with lowering the odds of obesity by 69% (25% to 88%) among children with normal growth. Conversely, among children with stunted growth, the continuation of breastmilk was associated with an increase in the odds of obesity by 3.71 (1.08 to 12.62) times. Conclusion: Despite the 4.9% reduction in paediatric obesity, cases of the nutritional paradox are still escalating in Pakistan. This reflects an urgent need for targeted nutritional interventions to mitigate the impact of obesogenic diets and reduce the prevalence of childhood obesity in Pakistan.

]]> Cross-Sectional Analysis of Food Group Consumption and Obesity in Children Aged 6–23 Months with Normal and Stunted Growth Patterns in Pakistan Asif Khaliq Izzan Ahmed Usmani Yusra Rizwan Mishaim Khan Akif Shahid Khan Noor ul Ain Saleem Muhammad Junaid doi: 10.3390/obesities5030055 Obesities 2025-07-16 Obesities 2025-07-16 5 3 Article 55 10.3390/obesities5030055 https://www.mdpi.com/2673-4168/5/3/55 Obesities, Vol. 5, Pages 54: Influences of Sex and BMI on Body Image, Weight Bias, Disordered Eating, and Psychological Well-Being: A Multivariate Analysis https://www.mdpi.com/2673-4168/5/3/54 Body image and mental health outcomes are influenced by both sex and body weight. This study investigated how sex and BMI category (participants classified with healthy weight, overweight, or with obesity) relate to body image, disordered eating, weight bias, global self-esteem and depression. Participants (N = 642; 278 (43.3%) males; 364 females (56,7%)) provided self-report measures of appearance satisfaction, body appreciation, overweight preoccupation, disordered eating scores, weight bias, depression, and self-esteem. The results indicated that women and participants classified with overweight and obesity based on BMI categories reported lower appearance satisfaction and body appreciation and a higher preoccupation with overweight and depression. Interaction effects showed that women participants with overweight and obesity reported particularly low appearance satisfaction and body appreciation. Individuals classified with healthy BMI category reported higher disordered eating scores than those classified with overweight. No significant effects were found for global self-esteem. These findings suggest that sex and BMI contribute to the study’s variables of interest, with some effects more pronounced in women with a higher BMI. The results align with sociocultural theories of appearance pressure but indicate complexity in disordered eating patterns. The findings underscore the importance of adopting intersectional, weight-inclusive, and sex-responsive approaches in both research and clinical practice. 2025-07-11 Obesities, Vol. 5, Pages 54: Influences of Sex and BMI on Body Image, Weight Bias, Disordered Eating, and Psychological Well-Being: A Multivariate Analysis

Obesities doi: 10.3390/obesities5030054

Authors: Marios Argyrides Lina Efthyvoulou Konstantina Zamba Elly Anastasiades Zoe Charalambous

Body image and mental health outcomes are influenced by both sex and body weight. This study investigated how sex and BMI category (participants classified with healthy weight, overweight, or with obesity) relate to body image, disordered eating, weight bias, global self-esteem and depression. Participants (N = 642; 278 (43.3%) males; 364 females (56,7%)) provided self-report measures of appearance satisfaction, body appreciation, overweight preoccupation, disordered eating scores, weight bias, depression, and self-esteem. The results indicated that women and participants classified with overweight and obesity based on BMI categories reported lower appearance satisfaction and body appreciation and a higher preoccupation with overweight and depression. Interaction effects showed that women participants with overweight and obesity reported particularly low appearance satisfaction and body appreciation. Individuals classified with healthy BMI category reported higher disordered eating scores than those classified with overweight. No significant effects were found for global self-esteem. These findings suggest that sex and BMI contribute to the study’s variables of interest, with some effects more pronounced in women with a higher BMI. The results align with sociocultural theories of appearance pressure but indicate complexity in disordered eating patterns. The findings underscore the importance of adopting intersectional, weight-inclusive, and sex-responsive approaches in both research and clinical practice.

]]> Influences of Sex and BMI on Body Image, Weight Bias, Disordered Eating, and Psychological Well-Being: A Multivariate Analysis Marios Argyrides Lina Efthyvoulou Konstantina Zamba Elly Anastasiades Zoe Charalambous doi: 10.3390/obesities5030054 Obesities 2025-07-11 Obesities 2025-07-11 5 3 Article 54 10.3390/obesities5030054 https://www.mdpi.com/2673-4168/5/3/54 Obesities, Vol. 5, Pages 53: Participant Experiences of Cognitive Remediation Therapy for Obesity (CRT-O): A Qualitative Thematic Analysis https://www.mdpi.com/2673-4168/5/3/53 Objective: The present study is a qualitative analysis of participant experiences and perspectives from people who received cognitive remediation therapy for adult obesity (CRT-O). Method: Post-intervention data were generated from an open-ended question requesting the participants to write, in the form of a letter to their therapist, about their experiences and reflections upon taking part in cognitive remediation therapy for adult obesity. Participants’ letters were thematically analyzed. Results: Four themes and nested subthemes emerged from participant responses, including (1) motivation and initial response to CRT-O for the adult obesity study eligibility process with the nested subthemes of initial apprehension pre-intervention and awareness and acknowledgement of one’s problematic eating behaviors; (2) perceived benefits from cognitive remediation therapy for adult obesity with the nested subthemes of the strategies and techniques that were found beneficial and the role of the cognitive remediation therapy for adult obesity therapists in facilitating positive change; (3) perceived outcomes post-intervention with the nested subthemes of changed relationship with food, self-acceptance and gaining control to effect positive lifestyle change; and (4) expectations and beliefs about the longer-term impact of cognitive remediation therapy for adult obesity with the nested subthemes of using the cognitive remediation therapy for adult obesity strategies as a lifestyle routine, apprehension about not having follow-up therapist support, and concern about potential relapse. Conclusion: Our analysis found helpful insights into the consumer perception of this novel intervention and highlighted the clinical utility of implementing cognitive remediation therapy in those living with a higher body weight. 2025-07-09 Obesities, Vol. 5, Pages 53: Participant Experiences of Cognitive Remediation Therapy for Obesity (CRT-O): A Qualitative Thematic Analysis

Obesities doi: 10.3390/obesities5030053

Authors: Jayanthi Raman Priyanka Thapliyal Evelyn Smith Aparna Anoop Phillipa Hay

Objective: The present study is a qualitative analysis of participant experiences and perspectives from people who received cognitive remediation therapy for adult obesity (CRT-O). Method: Post-intervention data were generated from an open-ended question requesting the participants to write, in the form of a letter to their therapist, about their experiences and reflections upon taking part in cognitive remediation therapy for adult obesity. Participants’ letters were thematically analyzed. Results: Four themes and nested subthemes emerged from participant responses, including (1) motivation and initial response to CRT-O for the adult obesity study eligibility process with the nested subthemes of initial apprehension pre-intervention and awareness and acknowledgement of one’s problematic eating behaviors; (2) perceived benefits from cognitive remediation therapy for adult obesity with the nested subthemes of the strategies and techniques that were found beneficial and the role of the cognitive remediation therapy for adult obesity therapists in facilitating positive change; (3) perceived outcomes post-intervention with the nested subthemes of changed relationship with food, self-acceptance and gaining control to effect positive lifestyle change; and (4) expectations and beliefs about the longer-term impact of cognitive remediation therapy for adult obesity with the nested subthemes of using the cognitive remediation therapy for adult obesity strategies as a lifestyle routine, apprehension about not having follow-up therapist support, and concern about potential relapse. Conclusion: Our analysis found helpful insights into the consumer perception of this novel intervention and highlighted the clinical utility of implementing cognitive remediation therapy in those living with a higher body weight.

]]> Participant Experiences of Cognitive Remediation Therapy for Obesity (CRT-O): A Qualitative Thematic Analysis Jayanthi Raman Priyanka Thapliyal Evelyn Smith Aparna Anoop Phillipa Hay doi: 10.3390/obesities5030053 Obesities 2025-07-09 Obesities 2025-07-09 5 3 Article 53 10.3390/obesities5030053 https://www.mdpi.com/2673-4168/5/3/53 Obesities, Vol. 5, Pages 52: Trends and Subgroup Comparisons of Obesity and Severe Obesity Prevalence Among Mississippi Adults, 2011–2021 https://www.mdpi.com/2673-4168/5/3/52 Mississippi has long been one of the most obese states in the U.S., with its obesity rates consistently exceeding the national average. The state’s severe obesity rate is also among the highest in the nation. This study utilized the 2011 to 2021 data from the Mississippi Behavioral Risk Factor Surveillance System (BRFSS) to conduct a comprehensive analysis of obesity and severe obesity trends in Mississippi by sex, age, and race and ethnicity. The data set included a BMI variable calculated by using self-reported height and weight, which the authors categorized into two obesity classification groups—obesity (BMI: 30.00 to 39.99) and severe obesity (BMI: 40.00 or greater)—and demographic characteristics such as sex, age, race and ethnicity. The data were analyzed using SAS 9.4 software to account for the complex design. Weighted prevalence estimates and associated standard errors (SEs) for obesity and severe obesity were calculated. Changes in the prevalence over time were assessed using logistic regression models. The prevalence estimates and SEs were exported to Joinpoint software to calculate the annual percentage change (APC) and associated 95% confidence intervals (CIs) and p-values for the trends. Our analysis of the data revealed a consistent increase in severe obesity, regardless of age, sex, or race. A concerning trend exists where individuals are moving from the obese category to the severely obese category, indicating a worsening trend in overall weight status. This is likely to accelerate the development of chronic disease and, hence, place additional strain on an economically disadvantaged state. Future research should explore the underlying drivers of this shift, including biological, behavioral, and socioeconomic factors, while also evaluating the effectiveness of existing obesity prevention and treatment programs. 2025-07-04 Obesities, Vol. 5, Pages 52: Trends and Subgroup Comparisons of Obesity and Severe Obesity Prevalence Among Mississippi Adults, 2011–2021

Obesities doi: 10.3390/obesities5030052

Authors: Stephanie McLeod Xiaoshan Z. Gordy Jana Bagwell Christina Ferrell Jerome Kolbo Lei Zhang

Mississippi has long been one of the most obese states in the U.S., with its obesity rates consistently exceeding the national average. The state’s severe obesity rate is also among the highest in the nation. This study utilized the 2011 to 2021 data from the Mississippi Behavioral Risk Factor Surveillance System (BRFSS) to conduct a comprehensive analysis of obesity and severe obesity trends in Mississippi by sex, age, and race and ethnicity. The data set included a BMI variable calculated by using self-reported height and weight, which the authors categorized into two obesity classification groups—obesity (BMI: 30.00 to 39.99) and severe obesity (BMI: 40.00 or greater)—and demographic characteristics such as sex, age, race and ethnicity. The data were analyzed using SAS 9.4 software to account for the complex design. Weighted prevalence estimates and associated standard errors (SEs) for obesity and severe obesity were calculated. Changes in the prevalence over time were assessed using logistic regression models. The prevalence estimates and SEs were exported to Joinpoint software to calculate the annual percentage change (APC) and associated 95% confidence intervals (CIs) and p-values for the trends. Our analysis of the data revealed a consistent increase in severe obesity, regardless of age, sex, or race. A concerning trend exists where individuals are moving from the obese category to the severely obese category, indicating a worsening trend in overall weight status. This is likely to accelerate the development of chronic disease and, hence, place additional strain on an economically disadvantaged state. Future research should explore the underlying drivers of this shift, including biological, behavioral, and socioeconomic factors, while also evaluating the effectiveness of existing obesity prevention and treatment programs.

]]> Trends and Subgroup Comparisons of Obesity and Severe Obesity Prevalence Among Mississippi Adults, 2011–2021 Stephanie McLeod Xiaoshan Z. Gordy Jana Bagwell Christina Ferrell Jerome Kolbo Lei Zhang doi: 10.3390/obesities5030052 Obesities 2025-07-04 Obesities 2025-07-04 5 3 Article 52 10.3390/obesities5030052 https://www.mdpi.com/2673-4168/5/3/52 Obesities, Vol. 5, Pages 51: Multicomponent-Type High-Intensity Interval Training Improves Vitamin D Status in Adults with Overweight/Obesity https://www.mdpi.com/2673-4168/5/3/51 Vitamin D deficiency is highly prevalent in individuals with overweight/obesity and this can be largely attributed to the entrapment of VitD in adipose tissue due to impaired lipolytic stimulation. Considering the well-described role of exercise in stimulating lipolysis, the present study investigated the efficacy of multicomponent-type high-intensity interval training (m-HIIT) in increasing 25-hydroxyvitamin D [25(OH)D] levels in males with overweight/obesity. Twenty middle-aged males (43.5 ± 5 years, BMI: 30.7 ± 3.3 kg/m2) participated in three weekly supervised m-HIIT sessions over a 12-week period and underwent assessments at baseline, 6, and 12 weeks. Primary outcomes were total body fat mass, android fat, hepatorenal index, and serum 25(OH)D. Participants’ daily physical activity and dietary intake habits remained unaltered throughout the 12-week training period. The m-HIIT intervention reduced fat mass (by 3% at 12 weeks), android fat (by 3.7% at 6 weeks and 4.4% at 12 weeks), and hepatorenal index (by 8% at 12 weeks). Serum 25(OH)D levels increased by ~14% (+3.21 ng/mL, p = 0.002) and ~31% (+7.24 ng/mL, p < 0.001) at 6 and 12 weeks, respectively. The elevation of 25(OH)D levels at 12 weeks was inversely related to fat mass loss (R = 0.53, p = 0.016). Plasma SGPT, SGOT, ALP, γ-GT, fetuin-A, and calcium levels remained unaltered after the 12-week training period. In conclusion, m-HIIT may be useful as a non-pharmacological intervention to increase circulating VitD levels in adults with overweight/obesity. 2025-07-04 Obesities, Vol. 5, Pages 51: Multicomponent-Type High-Intensity Interval Training Improves Vitamin D Status in Adults with Overweight/Obesity

Obesities doi: 10.3390/obesities5030051

Authors: Maria Protopapa Dimitrios Draganidis Alexandra Avloniti Ioannis G. Fatouros Theodoros Stampoulis Dimitrios Pantazis Dimitrios Balampanos Nikolaos Orestis Retzepis Athanasios Poulios Nikolaos Zaras Maria Bampali Ioannis Karakasiliotis George Mastorakos Theodore J. Angelopoulos Maria Michalopoulou Antonis Kambas Athanasios Z. Jamurtas Athanasios Chatzinikolaou

Vitamin D deficiency is highly prevalent in individuals with overweight/obesity and this can be largely attributed to the entrapment of VitD in adipose tissue due to impaired lipolytic stimulation. Considering the well-described role of exercise in stimulating lipolysis, the present study investigated the efficacy of multicomponent-type high-intensity interval training (m-HIIT) in increasing 25-hydroxyvitamin D [25(OH)D] levels in males with overweight/obesity. Twenty middle-aged males (43.5 ± 5 years, BMI: 30.7 ± 3.3 kg/m2) participated in three weekly supervised m-HIIT sessions over a 12-week period and underwent assessments at baseline, 6, and 12 weeks. Primary outcomes were total body fat mass, android fat, hepatorenal index, and serum 25(OH)D. Participants’ daily physical activity and dietary intake habits remained unaltered throughout the 12-week training period. The m-HIIT intervention reduced fat mass (by 3% at 12 weeks), android fat (by 3.7% at 6 weeks and 4.4% at 12 weeks), and hepatorenal index (by 8% at 12 weeks). Serum 25(OH)D levels increased by ~14% (+3.21 ng/mL, p = 0.002) and ~31% (+7.24 ng/mL, p < 0.001) at 6 and 12 weeks, respectively. The elevation of 25(OH)D levels at 12 weeks was inversely related to fat mass loss (R = 0.53, p = 0.016). Plasma SGPT, SGOT, ALP, γ-GT, fetuin-A, and calcium levels remained unaltered after the 12-week training period. In conclusion, m-HIIT may be useful as a non-pharmacological intervention to increase circulating VitD levels in adults with overweight/obesity.

]]> Multicomponent-Type High-Intensity Interval Training Improves Vitamin D Status in Adults with Overweight/Obesity Maria Protopapa Dimitrios Draganidis Alexandra Avloniti Ioannis G. Fatouros Theodoros Stampoulis Dimitrios Pantazis Dimitrios Balampanos Nikolaos Orestis Retzepis Athanasios Poulios Nikolaos Zaras Maria Bampali Ioannis Karakasiliotis George Mastorakos Theodore J. Angelopoulos Maria Michalopoulou Antonis Kambas Athanasios Z. Jamurtas Athanasios Chatzinikolaou doi: 10.3390/obesities5030051 Obesities 2025-07-04 Obesities 2025-07-04 5 3 Brief Report 51 10.3390/obesities5030051 https://www.mdpi.com/2673-4168/5/3/51 Obesities, Vol. 5, Pages 50: Investigating Environmental and Socioeconomic Contributors to Adult Obesity in the Rio Grande Valley https://www.mdpi.com/2673-4168/5/3/50 Obesity in the Rio Grande Valley (RGV) of Texas remains a critical public health concern, with rates (46.9%) significantly exceeding those of Texas (36%) and the U.S. (34%) (p < 0.001). This study used 2024 County Health Rankings data to analyze environmental and socioeconomic contributors to obesity across 240 Texas counties, with a population-weighted focus on Hidalgo, Cameron, Starr, and Willacy counties. The RGV exhibited markedly poorer access to exercise, higher rates of physical inactivity, lower Food Environment Index scores (FEI = 4.3 vs. 5.7 in Texas), higher rates of uninsurance, worse patient-to–primary care physician (PCP) ratios (2152:1 vs. Texas 1660:1), and increased preventable hospitalizations. Multiple linear regression identified physical inactivity (β = 0.6, p = 0.01) and access to exercise (β = −0.02, p = 0.02) as significant predictors of obesity. Notably, higher uninsured rates were associated with lower reported obesity, likely due to underdiagnosis in the absence of routine care. These findings emphasize the need for targeted interventions addressing food access, environmental and recreational infrastructure, along with healthcare infrastructure in the RGV, where socioeconomic disadvantage and structural barriers magnify the impact of national obesity trends on the regional level. 2025-07-01 Obesities, Vol. 5, Pages 50: Investigating Environmental and Socioeconomic Contributors to Adult Obesity in the Rio Grande Valley

Obesities doi: 10.3390/obesities5030050

Authors: John Nicholas Cauba Jihoo Woo Russell W. Wiggins Shizue Mito

Obesity in the Rio Grande Valley (RGV) of Texas remains a critical public health concern, with rates (46.9%) significantly exceeding those of Texas (36%) and the U.S. (34%) (p < 0.001). This study used 2024 County Health Rankings data to analyze environmental and socioeconomic contributors to obesity across 240 Texas counties, with a population-weighted focus on Hidalgo, Cameron, Starr, and Willacy counties. The RGV exhibited markedly poorer access to exercise, higher rates of physical inactivity, lower Food Environment Index scores (FEI = 4.3 vs. 5.7 in Texas), higher rates of uninsurance, worse patient-to–primary care physician (PCP) ratios (2152:1 vs. Texas 1660:1), and increased preventable hospitalizations. Multiple linear regression identified physical inactivity (β = 0.6, p = 0.01) and access to exercise (β = −0.02, p = 0.02) as significant predictors of obesity. Notably, higher uninsured rates were associated with lower reported obesity, likely due to underdiagnosis in the absence of routine care. These findings emphasize the need for targeted interventions addressing food access, environmental and recreational infrastructure, along with healthcare infrastructure in the RGV, where socioeconomic disadvantage and structural barriers magnify the impact of national obesity trends on the regional level.

]]> Investigating Environmental and Socioeconomic Contributors to Adult Obesity in the Rio Grande Valley John Nicholas Cauba Jihoo Woo Russell W. Wiggins Shizue Mito doi: 10.3390/obesities5030050 Obesities 2025-07-01 Obesities 2025-07-01 5 3 Article 50 10.3390/obesities5030050 https://www.mdpi.com/2673-4168/5/3/50 Obesities, Vol. 5, Pages 49: “I Don’t Approve of a Fat Person…”: A Cross-Sectional Survey Exploring the Perceptions of Health, Weight and Obesity https://www.mdpi.com/2673-4168/5/3/49 Despite being acknowledged as a complex and multi-faceted condition, the prevailing view within society is that obesity is the result of individual choices and can be reversed simply by “eating less and moving more”. This is oversimplistic and leads to the view that obesity is the individual’s fault and is therefore their responsibility to remedy. These views are grounded in individuals’ beliefs around health and contribute to weight bias and stigma. In the present study, participants (n = 143) completed a cross-sectional survey which explored views around weight and health and whether weight bias or stigma differed based on demographic characteristics, weight status, and prior experience of weight stigma. Results indicate differences in the way individuals living with overweight and obesity are viewed in comparison with those of a healthy weight, with the former viewed in a more negative light. Interestingly, while women presented with higher weight bias scores (p = 0.036), men scored higher for externalised weight stigma (p = 0.001). Weight status was seen as an important factor contributing to overall health. These results demonstrate that weight bias and stigma are prevalent and highlight the need for further measures to reduce stigmatising views of people living with overweight and obesity. 2025-06-20 Obesities, Vol. 5, Pages 49: “I Don’t Approve of a Fat Person…”: A Cross-Sectional Survey Exploring the Perceptions of Health, Weight and Obesity

Obesities doi: 10.3390/obesities5030049

Authors: Jordan D. Beaumont Tina Reimann Rosie Wyld Beverley O’Hara

Despite being acknowledged as a complex and multi-faceted condition, the prevailing view within society is that obesity is the result of individual choices and can be reversed simply by “eating less and moving more”. This is oversimplistic and leads to the view that obesity is the individual’s fault and is therefore their responsibility to remedy. These views are grounded in individuals’ beliefs around health and contribute to weight bias and stigma. In the present study, participants (n = 143) completed a cross-sectional survey which explored views around weight and health and whether weight bias or stigma differed based on demographic characteristics, weight status, and prior experience of weight stigma. Results indicate differences in the way individuals living with overweight and obesity are viewed in comparison with those of a healthy weight, with the former viewed in a more negative light. Interestingly, while women presented with higher weight bias scores (p = 0.036), men scored higher for externalised weight stigma (p = 0.001). Weight status was seen as an important factor contributing to overall health. These results demonstrate that weight bias and stigma are prevalent and highlight the need for further measures to reduce stigmatising views of people living with overweight and obesity.

]]> “I Don’t Approve of a Fat Person…”: A Cross-Sectional Survey Exploring the Perceptions of Health, Weight and Obesity Jordan D. Beaumont Tina Reimann Rosie Wyld Beverley O’Hara doi: 10.3390/obesities5030049 Obesities 2025-06-20 Obesities 2025-06-20 5 3 Article 49 10.3390/obesities5030049 https://www.mdpi.com/2673-4168/5/3/49 Obesities, Vol. 5, Pages 48: The Impact of Sleep Deprivation on Hunger-Related Hormones: A Meta-Analysis and Systematic Review https://www.mdpi.com/2673-4168/5/2/48 Introduction: Short sleep duration has been implicated in an increased body mass index (BMI), potentially through disruptions in appetite-regulating hormones, such as leptin and ghrelin. Methods: This systematic review and meta-analysis aimed to examine the effects of sleep deprivation on circulating levels of these hunger hormones and their possible role in obesity. Six randomized controlled trials (RCTs) involving 141 participants were included in the analysis, with sleep deprivation typically manipulated through restricting sleep by 4–5 h or keeping participants awake for 24 h. Data on leptin and ghrelin levels were extracted from blood samples, and statistical analysis was conducted using a random-effects model. Results: The results revealed no significant changes in ghrelin (SMD: −0.27, 95% CI: −1.00, 0.46, p = 0.4712) or leptin (SMD: 0.10, 95% CI: −0.22, 0.42, p = 0.5266) levels following sleep deprivation, contrary to prior studies suggesting a link between sleep loss and altered appetite regulation. Significant heterogeneity was observed for ghrelin levels (I2 = 83.83%, p < 0.001), but not for leptin (I2 = 21.86%, p = 0.4049). Variations in study design, including differences in blood sampling timing and participant BMI, may explain this variability. Conclusions: These findings suggest that, at least in the short term, sleep deprivation does not consistently affect leptin and ghrelin levels. Given the complex relationship between sleep and appetite regulation, future research should focus on standardized study designs, participant characteristics, and more precise measurements to further explore these mechanisms. 2025-06-19 Obesities, Vol. 5, Pages 48: The Impact of Sleep Deprivation on Hunger-Related Hormones: A Meta-Analysis and Systematic Review

Obesities doi: 10.3390/obesities5020048

Authors: Delaney Gresser Kelsey McLimans Sheldon Lee Maria Morgan-Bathke

Introduction: Short sleep duration has been implicated in an increased body mass index (BMI), potentially through disruptions in appetite-regulating hormones, such as leptin and ghrelin. Methods: This systematic review and meta-analysis aimed to examine the effects of sleep deprivation on circulating levels of these hunger hormones and their possible role in obesity. Six randomized controlled trials (RCTs) involving 141 participants were included in the analysis, with sleep deprivation typically manipulated through restricting sleep by 4–5 h or keeping participants awake for 24 h. Data on leptin and ghrelin levels were extracted from blood samples, and statistical analysis was conducted using a random-effects model. Results: The results revealed no significant changes in ghrelin (SMD: −0.27, 95% CI: −1.00, 0.46, p = 0.4712) or leptin (SMD: 0.10, 95% CI: −0.22, 0.42, p = 0.5266) levels following sleep deprivation, contrary to prior studies suggesting a link between sleep loss and altered appetite regulation. Significant heterogeneity was observed for ghrelin levels (I2 = 83.83%, p < 0.001), but not for leptin (I2 = 21.86%, p = 0.4049). Variations in study design, including differences in blood sampling timing and participant BMI, may explain this variability. Conclusions: These findings suggest that, at least in the short term, sleep deprivation does not consistently affect leptin and ghrelin levels. Given the complex relationship between sleep and appetite regulation, future research should focus on standardized study designs, participant characteristics, and more precise measurements to further explore these mechanisms.

]]> The Impact of Sleep Deprivation on Hunger-Related Hormones: A Meta-Analysis and Systematic Review Delaney Gresser Kelsey McLimans Sheldon Lee Maria Morgan-Bathke doi: 10.3390/obesities5020048 Obesities 2025-06-19 Obesities 2025-06-19 5 2 Systematic Review 48 10.3390/obesities5020048 https://www.mdpi.com/2673-4168/5/2/48 Obesities, Vol. 5, Pages 47: A 10-Year Summary of Health Fair Data from Lakota, Powwows, and Red Shawl Events in the Rural Midwest https://www.mdpi.com/2673-4168/5/2/47 Objectives—Health screening data were collected from participants at Native American community and celebratory events to evaluate their health status and identify common health concerns. These results will form the basis for developing community-based health care interventions to address health inequalities. Design—A descriptive, observational design was used to gather data in line with STROBE guidelines. Results—The screening data revealed that this population was largely obese, had low bone mass, and were in various states of dehydration. These characteristics can lead to major health risks and morbidities including diabetes, hypertension, cancer, hormone and neurotransmitter imbalances, bone fractures, and psychological disorders such as depression and anxiety. Conclusions—Professional and community efforts are essential to meet the health care needs of this population and avoid the repercussions of obesity, low bone mass, and dehydration. By incorporating collaborative input from the Native American community, we intend to develop partnerships for goals of promoting effective, culturally appropriate interventions to meet these health inequalities and promote good health and well-being. 2025-06-17 Obesities, Vol. 5, Pages 47: A 10-Year Summary of Health Fair Data from Lakota, Powwows, and Red Shawl Events in the Rural Midwest

Obesities doi: 10.3390/obesities5020047

Authors: Trina Aguirre

Objectives—Health screening data were collected from participants at Native American community and celebratory events to evaluate their health status and identify common health concerns. These results will form the basis for developing community-based health care interventions to address health inequalities. Design—A descriptive, observational design was used to gather data in line with STROBE guidelines. Results—The screening data revealed that this population was largely obese, had low bone mass, and were in various states of dehydration. These characteristics can lead to major health risks and morbidities including diabetes, hypertension, cancer, hormone and neurotransmitter imbalances, bone fractures, and psychological disorders such as depression and anxiety. Conclusions—Professional and community efforts are essential to meet the health care needs of this population and avoid the repercussions of obesity, low bone mass, and dehydration. By incorporating collaborative input from the Native American community, we intend to develop partnerships for goals of promoting effective, culturally appropriate interventions to meet these health inequalities and promote good health and well-being.

]]> A 10-Year Summary of Health Fair Data from Lakota, Powwows, and Red Shawl Events in the Rural Midwest Trina Aguirre doi: 10.3390/obesities5020047 Obesities 2025-06-17 Obesities 2025-06-17 5 2 Brief Report 47 10.3390/obesities5020047 https://www.mdpi.com/2673-4168/5/2/47 Obesities, Vol. 5, Pages 46: Weight Stigma in Physical and Occupational Therapy: A Scoping Review https://www.mdpi.com/2673-4168/5/2/46 Background: Weight stigma describes the negative attitudes held toward people with obesity. Weight bias stereotypes have been previously reported in physicians, physician assistants, nurses, registered dieticians, psychologists, and students enrolled in healthcare professional education programs. Physical and occupational therapists (PTs and OTs) are healthcare providers who evaluate and treat individuals across their lifespan. A PT or an OT who harbors weight bias may create an environment where the patient may fail to optimize their rehabilitation recovery. The first purpose of this scoping review was to identify the prevalence of weight bias in PT and OT clinicians and students. The second purpose was to evaluate the effectiveness of interventions at reducing weight bias in these populations. Methods: The CINAHL, PubMed, and Google Scholar databases were searched, and 15 articles met the inclusion criteria. Results: In each study, PT and/or OT clinicians and/or students demonstrated weight bias. A minimum of approximately twenty percent of surveyed participants had weight bias, with one study reporting over eighty percent of subjects expressing negative attitudes. Three of the studies reported mixed results (i.e., improvement or worsening) regarding weight bias scores after intervention. Conclusions: PT and OT clinicians and students demonstrate weight bias similar to other healthcare professionals. Future research is warranted to identify educational interventions that reduce bias within these populations. 2025-06-12 Obesities, Vol. 5, Pages 46: Weight Stigma in Physical and Occupational Therapy: A Scoping Review

Obesities doi: 10.3390/obesities5020046

Authors: Jason Brumitt Katherine Turner

Background: Weight stigma describes the negative attitudes held toward people with obesity. Weight bias stereotypes have been previously reported in physicians, physician assistants, nurses, registered dieticians, psychologists, and students enrolled in healthcare professional education programs. Physical and occupational therapists (PTs and OTs) are healthcare providers who evaluate and treat individuals across their lifespan. A PT or an OT who harbors weight bias may create an environment where the patient may fail to optimize their rehabilitation recovery. The first purpose of this scoping review was to identify the prevalence of weight bias in PT and OT clinicians and students. The second purpose was to evaluate the effectiveness of interventions at reducing weight bias in these populations. Methods: The CINAHL, PubMed, and Google Scholar databases were searched, and 15 articles met the inclusion criteria. Results: In each study, PT and/or OT clinicians and/or students demonstrated weight bias. A minimum of approximately twenty percent of surveyed participants had weight bias, with one study reporting over eighty percent of subjects expressing negative attitudes. Three of the studies reported mixed results (i.e., improvement or worsening) regarding weight bias scores after intervention. Conclusions: PT and OT clinicians and students demonstrate weight bias similar to other healthcare professionals. Future research is warranted to identify educational interventions that reduce bias within these populations.

]]> Weight Stigma in Physical and Occupational Therapy: A Scoping Review Jason Brumitt Katherine Turner doi: 10.3390/obesities5020046 Obesities 2025-06-12 Obesities 2025-06-12 5 2 Review 46 10.3390/obesities5020046 https://www.mdpi.com/2673-4168/5/2/46 Obesities, Vol. 5, Pages 45: Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study https://www.mdpi.com/2673-4168/5/2/45 Binge eating is the cardinal feature of Binge-Eating Disorder (BED) and is known to be associated with obesity with bidirectional causality. This study aimed to investigate the association of diagnostic specifiers of binge eating, as mandated in the DSM-5 definition of BED, i.e., Criteria B and C (presence of marked distress) and weight/shape overvaluation with body mass index (BMI); and to examine the associations of high BMI with distress, pain, anxiety, and physical and mental health-related quality of life (PHRQoL and MHRQoL). Data for a sub-sample of 255 adults with recurrent binge eating (Criterion A) and without anorexia or bulimia nervosa diagnoses were extracted from the 2017 South Australian Health Omnibus Survey. Bivariate analyses were used to explore the association of DSM-5 BED specifiers with BMI and other measures. This study found that specific BED diagnostic specifiers related to binge eating were associated with higher BMI and distress levels. Additionally, individuals with BED who experience weight/shape overvaluation and higher BMI levels were associated with heigh levels of pain and anxiety, and had poorer PHRQoL and MHRQoL. These findings in relation to the association of higher BMI with different BED specifiers support the clinical significance of the DSM-5 Criterion B and C for BED. 2025-06-10 Obesities, Vol. 5, Pages 45: Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study

Obesities doi: 10.3390/obesities5020045

Authors: Mohammed Mohsin Malakeh Hamoui Stella Kozmér Stephen Touyz David Currow Phillipa Hay

Binge eating is the cardinal feature of Binge-Eating Disorder (BED) and is known to be associated with obesity with bidirectional causality. This study aimed to investigate the association of diagnostic specifiers of binge eating, as mandated in the DSM-5 definition of BED, i.e., Criteria B and C (presence of marked distress) and weight/shape overvaluation with body mass index (BMI); and to examine the associations of high BMI with distress, pain, anxiety, and physical and mental health-related quality of life (PHRQoL and MHRQoL). Data for a sub-sample of 255 adults with recurrent binge eating (Criterion A) and without anorexia or bulimia nervosa diagnoses were extracted from the 2017 South Australian Health Omnibus Survey. Bivariate analyses were used to explore the association of DSM-5 BED specifiers with BMI and other measures. This study found that specific BED diagnostic specifiers related to binge eating were associated with higher BMI and distress levels. Additionally, individuals with BED who experience weight/shape overvaluation and higher BMI levels were associated with heigh levels of pain and anxiety, and had poorer PHRQoL and MHRQoL. These findings in relation to the association of higher BMI with different BED specifiers support the clinical significance of the DSM-5 Criterion B and C for BED.

]]> Investigating Associations Between the Diagnostic Specifiers for Binge-Eating Disorder, Other Clinical Features, and the Presence of a High Body Mass Index: A Population-Based Study Mohammed Mohsin Malakeh Hamoui Stella Kozmér Stephen Touyz David Currow Phillipa Hay doi: 10.3390/obesities5020045 Obesities 2025-06-10 Obesities 2025-06-10 5 2 Article 45 10.3390/obesities5020045 https://www.mdpi.com/2673-4168/5/2/45 Obesities, Vol. 5, Pages 44: Hyper-Visible Yet Invisible: Exploring the Body Image Experiences of Overweight Women in Everyday Life https://www.mdpi.com/2673-4168/5/2/44 Weight stigma remains a pervasive issue in contemporary society, impacting individuals’ psychological well-being, social inclusion, and access to opportunities. This study explored the lived experiences of overweight women, focusing on body image, stigma, and engagement with dominant health and beauty norms. Using a qualitative, phenomenological approach, online in-depth interviews were conducted with 14 women aged 25 to 51, primarily residing in southern and eastern Europe (Greece, Cyprus, Albania, Romania, and Bulgaria), with three participants from the United Kingdom. Thematic analysis revealed four key themes: workplace discrimination, pressures during pregnancy and the postpartum period, ambivalence toward body positivity movements, and the emotional toll of stigma, including extreme coping strategies. Participants described being marginalized professionally, scrutinized publicly and within families, and caught between ideals of inclusivity and persistent societal rejection. The findings emphasize the psychological burden of weight-based discrimination and the superficial nature of many body acceptance campaigns. This study calls for structural changes in healthcare, media, and employment practices to support body diversity and dismantle entrenched biases. By centering the voices of overweight women, the research contributes to broader discussions on embodiment, social justice, and intersectionality within the field of body image scholarship. 2025-06-06 Obesities, Vol. 5, Pages 44: Hyper-Visible Yet Invisible: Exploring the Body Image Experiences of Overweight Women in Everyday Life

Obesities doi: 10.3390/obesities5020044

Authors: Panagiota Tragantzopoulou

Weight stigma remains a pervasive issue in contemporary society, impacting individuals’ psychological well-being, social inclusion, and access to opportunities. This study explored the lived experiences of overweight women, focusing on body image, stigma, and engagement with dominant health and beauty norms. Using a qualitative, phenomenological approach, online in-depth interviews were conducted with 14 women aged 25 to 51, primarily residing in southern and eastern Europe (Greece, Cyprus, Albania, Romania, and Bulgaria), with three participants from the United Kingdom. Thematic analysis revealed four key themes: workplace discrimination, pressures during pregnancy and the postpartum period, ambivalence toward body positivity movements, and the emotional toll of stigma, including extreme coping strategies. Participants described being marginalized professionally, scrutinized publicly and within families, and caught between ideals of inclusivity and persistent societal rejection. The findings emphasize the psychological burden of weight-based discrimination and the superficial nature of many body acceptance campaigns. This study calls for structural changes in healthcare, media, and employment practices to support body diversity and dismantle entrenched biases. By centering the voices of overweight women, the research contributes to broader discussions on embodiment, social justice, and intersectionality within the field of body image scholarship.

]]> Hyper-Visible Yet Invisible: Exploring the Body Image Experiences of Overweight Women in Everyday Life Panagiota Tragantzopoulou doi: 10.3390/obesities5020044 Obesities 2025-06-06 Obesities 2025-06-06 5 2 Article 44 10.3390/obesities5020044 https://www.mdpi.com/2673-4168/5/2/44 Obesities, Vol. 5, Pages 43: A Narrative Review of the Mediterranean Lifestyle and Its Role in Obesity Prevention and Management https://www.mdpi.com/2673-4168/5/2/43 The Mediterranean lifestyle (ML), encompassing key elements such as the Mediterranean diet (MD), regular physical activity, social engagement, sleep-enhancing habits, sustainable food practices, including reducing food waste and opting for seasonal and local products, proximity to nature, and a focus on slow living, has garnered increasing interest for its potential in obesity prevention and management. This narrative review examines how these lifestyle characteristics may influence body weight regulation, metabolic health, and obesity-related outcomes. A thorough literature search was conducted to synthesize findings from epidemiological studies, clinical trials, and mechanistic research. Evidence suggests that adherence to the MD is linked to lower obesity rates, improved metabolic markers, and reduced risk of weight gain. Key components contributing to these effects include high fiber intake, healthy fatty acids from olive oil and nuts, and a balanced macronutrient profile that promotes satiety and reduces inflammation. Furthermore, lifestyle practices such as regular physical activity, strong social connections, and sleep-enhancing habits may further support weight management. Despite consistently favorable findings in observational studies, intervention trials reveal variability in individual responses, highlighting the need for personalized approaches. Future research should explore strategies to enhance adherence to the MD and investigate the interactions between diet, physical activity, and psychosocial factors in obesity prevention. 2025-06-05 Obesities, Vol. 5, Pages 43: A Narrative Review of the Mediterranean Lifestyle and Its Role in Obesity Prevention and Management

Obesities doi: 10.3390/obesities5020043

Authors: Sotiria Laoutari Efstratios Christodoulou Antonios E. Koutelidakis

The Mediterranean lifestyle (ML), encompassing key elements such as the Mediterranean diet (MD), regular physical activity, social engagement, sleep-enhancing habits, sustainable food practices, including reducing food waste and opting for seasonal and local products, proximity to nature, and a focus on slow living, has garnered increasing interest for its potential in obesity prevention and management. This narrative review examines how these lifestyle characteristics may influence body weight regulation, metabolic health, and obesity-related outcomes. A thorough literature search was conducted to synthesize findings from epidemiological studies, clinical trials, and mechanistic research. Evidence suggests that adherence to the MD is linked to lower obesity rates, improved metabolic markers, and reduced risk of weight gain. Key components contributing to these effects include high fiber intake, healthy fatty acids from olive oil and nuts, and a balanced macronutrient profile that promotes satiety and reduces inflammation. Furthermore, lifestyle practices such as regular physical activity, strong social connections, and sleep-enhancing habits may further support weight management. Despite consistently favorable findings in observational studies, intervention trials reveal variability in individual responses, highlighting the need for personalized approaches. Future research should explore strategies to enhance adherence to the MD and investigate the interactions between diet, physical activity, and psychosocial factors in obesity prevention.

]]> A Narrative Review of the Mediterranean Lifestyle and Its Role in Obesity Prevention and Management Sotiria Laoutari Efstratios Christodoulou Antonios E. Koutelidakis doi: 10.3390/obesities5020043 Obesities 2025-06-05 Obesities 2025-06-05 5 2 Review 43 10.3390/obesities5020043 https://www.mdpi.com/2673-4168/5/2/43 Obesities, Vol. 5, Pages 42: The Role of Whey Protein in Maintaining Fat-Free Mass and Promoting Fat Loss After 18 Months of Bariatric Surgery https://www.mdpi.com/2673-4168/5/2/42 Introduction: Adequate protein intake is essential for maintaining lean body mass during weight loss, particularly for patients undergoing bariatric surgery (BS). Whey protein supplementation may help meet daily protein requirements. This study aimed to assess the effects of whey protein supplementation on weight loss and body composition in women during the medium-term postoperative phase following BS. Methods: In a double-blind, controlled study over four weeks, 24 women received 30 g of whey protein (Whey group), while 19 received 30 g of maltodextrin (Malto group). Body composition, energy expenditure, muscle thickness, muscle strength, walking performance, and dietary intake were evaluated. Results: Compared to the Malto group, the Whey group showed greater reductions in body weight (median: −0.6 kg vs. −0.2 kg, respectively) and fat mass (median: −1.1 kg vs. −0.25 kg, respectively), along with an increase in fat-free mass (−0.7 kg vs. 0.6 kg, respectively). Muscle thickness improved in the Whey compared to the Malto group in the abdominal (0.07 mm vs. −0.04 mm, respectively) and thigh (0.4 mm vs. −0.15 mm, respectively) regions. Additionally, muscle mass reduction was less pronounced in the Whey group (−3 kg vs. −0.13 kg). No significant differences were observed in handgrip strength, gait speed, or nutrient intake. Conclusions: Whey protein supplementation may be beneficial, as it enhances weight loss and preserves fat-free and muscle mass more effectively than a diet without this supplementation in women during the stabilization phase or late postoperative period of BS. 2025-06-05 Obesities, Vol. 5, Pages 42: The Role of Whey Protein in Maintaining Fat-Free Mass and Promoting Fat Loss After 18 Months of Bariatric Surgery

Obesities doi: 10.3390/obesities5020042

Authors: Hirla Karen Fialho Henriques Fabiana Martins Kattah Matheus Soares Piccolo Elandia Aparecida dos Santos Lucas Haniel de Araújo Ventura Flávia Rodrigues Cerqueira Claudia Maria Andrade Fernandes Vieira Jacqueline Isaura Alvarez Leite

Introduction: Adequate protein intake is essential for maintaining lean body mass during weight loss, particularly for patients undergoing bariatric surgery (BS). Whey protein supplementation may help meet daily protein requirements. This study aimed to assess the effects of whey protein supplementation on weight loss and body composition in women during the medium-term postoperative phase following BS. Methods: In a double-blind, controlled study over four weeks, 24 women received 30 g of whey protein (Whey group), while 19 received 30 g of maltodextrin (Malto group). Body composition, energy expenditure, muscle thickness, muscle strength, walking performance, and dietary intake were evaluated. Results: Compared to the Malto group, the Whey group showed greater reductions in body weight (median: −0.6 kg vs. −0.2 kg, respectively) and fat mass (median: −1.1 kg vs. −0.25 kg, respectively), along with an increase in fat-free mass (−0.7 kg vs. 0.6 kg, respectively). Muscle thickness improved in the Whey compared to the Malto group in the abdominal (0.07 mm vs. −0.04 mm, respectively) and thigh (0.4 mm vs. −0.15 mm, respectively) regions. Additionally, muscle mass reduction was less pronounced in the Whey group (−3 kg vs. −0.13 kg). No significant differences were observed in handgrip strength, gait speed, or nutrient intake. Conclusions: Whey protein supplementation may be beneficial, as it enhances weight loss and preserves fat-free and muscle mass more effectively than a diet without this supplementation in women during the stabilization phase or late postoperative period of BS.

]]> The Role of Whey Protein in Maintaining Fat-Free Mass and Promoting Fat Loss After 18 Months of Bariatric Surgery Hirla Karen Fialho Henriques Fabiana Martins Kattah Matheus Soares Piccolo Elandia Aparecida dos Santos Lucas Haniel de Araújo Ventura Flávia Rodrigues Cerqueira Claudia Maria Andrade Fernandes Vieira Jacqueline Isaura Alvarez Leite doi: 10.3390/obesities5020042 Obesities 2025-06-05 Obesities 2025-06-05 5 2 Article 42 10.3390/obesities5020042 https://www.mdpi.com/2673-4168/5/2/42 Obesities, Vol. 5, Pages 41: Anti-Fat Attitudes Towards Weight Gain Caused by the COVID-19 Pandemic or by “Unhealthy” Lifestyle Choices https://www.mdpi.com/2673-4168/5/2/41 Given the ubiquity of anti-fat prejudice, in this experimental study, we tested whether weight gain attributed to COVID-19 would influence evaluations of overweight male and female targets. Female participants (N = 160) were randomly assigned to read one of four mock medical forms that outlined distractor medical information (e.g., blood requisition results), the sex of the target (male vs. female) and stated reason for weight gain (unhealthy lifestyle choices vs. inactivity due to the COVID-19 lockdown). Participants evaluated the patient on a series of binary adjectives (e.g., lazy/industrious), and completed measures assessing anti-fat attitudes (i.e., fear of becoming fat and belief in the controllability of weight), internalization of ideal standards of appearance, and BMI (i.e., self-reported weight and height). Contrary to our predictions, we found that overweight male and female patients were evaluated similarly regardless of whether their weight gain was attributable to unhealthy lifestyle choices or inactivity due to the COVID-19 pandemic. Finally, believing that one’s weight is controllable and internalizing general standards of attractiveness correlated positively with fat disparagement of the medical patients. Participants’ BMI and fear of fat, however, were negligibly related to fat disparagement. Possible explanations for our findings, implications for healthcare settings, and directions for future research are explored. 2025-06-03 Obesities, Vol. 5, Pages 41: Anti-Fat Attitudes Towards Weight Gain Caused by the COVID-19 Pandemic or by “Unhealthy” Lifestyle Choices

Obesities doi: 10.3390/obesities5020041

Authors: Daniel Regan Mackenzie Bjornerud Mark J. Kiss Melanie A. Morrison Todd G. Morrison

Given the ubiquity of anti-fat prejudice, in this experimental study, we tested whether weight gain attributed to COVID-19 would influence evaluations of overweight male and female targets. Female participants (N = 160) were randomly assigned to read one of four mock medical forms that outlined distractor medical information (e.g., blood requisition results), the sex of the target (male vs. female) and stated reason for weight gain (unhealthy lifestyle choices vs. inactivity due to the COVID-19 lockdown). Participants evaluated the patient on a series of binary adjectives (e.g., lazy/industrious), and completed measures assessing anti-fat attitudes (i.e., fear of becoming fat and belief in the controllability of weight), internalization of ideal standards of appearance, and BMI (i.e., self-reported weight and height). Contrary to our predictions, we found that overweight male and female patients were evaluated similarly regardless of whether their weight gain was attributable to unhealthy lifestyle choices or inactivity due to the COVID-19 pandemic. Finally, believing that one’s weight is controllable and internalizing general standards of attractiveness correlated positively with fat disparagement of the medical patients. Participants’ BMI and fear of fat, however, were negligibly related to fat disparagement. Possible explanations for our findings, implications for healthcare settings, and directions for future research are explored.

]]> Anti-Fat Attitudes Towards Weight Gain Caused by the COVID-19 Pandemic or by “Unhealthy” Lifestyle Choices Daniel Regan Mackenzie Bjornerud Mark J. Kiss Melanie A. Morrison Todd G. Morrison doi: 10.3390/obesities5020041 Obesities 2025-06-03 Obesities 2025-06-03 5 2 Article 41 10.3390/obesities5020041 https://www.mdpi.com/2673-4168/5/2/41 Obesities, Vol. 5, Pages 40: Feminism and Its Associations with Weight Stigma, Body Image, and Disordered Eating: A Risk or Protective Factor? https://www.mdpi.com/2673-4168/5/2/40 The feminist perspective is relevant to the understanding, prevention, and treatment of disturbances in eating and body image. However, limited empirical research has explored the relationship between feminist identity and weight stigma. The present study examined the associations between feminist beliefs, externalized weight bias, internalized weight bias, body image, and eating disturbances. Two hundred sixty-five racially and ethnically diverse young women were recruited from a university in the Pacific Rim. Participants completed questionnaires online and interrelationships were examined using a series of regressions. Externalized weight bias was significantly negatively associated with both feminist beliefs and identification as a feminist. However, stronger feminist beliefs and identity were significantly associated with higher internalized weight bias, worse body dissatisfaction, and greater incidence of eating disturbances. The results of the present study suggest that structural change driven by feminist values and principles may be effective for reducing weight bias and possibly other risk factors present in broader society but potentially less effective on an individual level. Longitudinal research is needed to confirm the direction of these relationships and to understand which components of feminist theory and feminist values can be most helpful in reducing weight bias on an individual level, while still addressing structural change. 2025-06-01 Obesities, Vol. 5, Pages 40: Feminism and Its Associations with Weight Stigma, Body Image, and Disordered Eating: A Risk or Protective Factor?

Obesities doi: 10.3390/obesities5020040

Authors: Brooke L. Bennett Allison F. Wagner Rebecca M. Puhl Alexis Lamere Janet D. Latner

The feminist perspective is relevant to the understanding, prevention, and treatment of disturbances in eating and body image. However, limited empirical research has explored the relationship between feminist identity and weight stigma. The present study examined the associations between feminist beliefs, externalized weight bias, internalized weight bias, body image, and eating disturbances. Two hundred sixty-five racially and ethnically diverse young women were recruited from a university in the Pacific Rim. Participants completed questionnaires online and interrelationships were examined using a series of regressions. Externalized weight bias was significantly negatively associated with both feminist beliefs and identification as a feminist. However, stronger feminist beliefs and identity were significantly associated with higher internalized weight bias, worse body dissatisfaction, and greater incidence of eating disturbances. The results of the present study suggest that structural change driven by feminist values and principles may be effective for reducing weight bias and possibly other risk factors present in broader society but potentially less effective on an individual level. Longitudinal research is needed to confirm the direction of these relationships and to understand which components of feminist theory and feminist values can be most helpful in reducing weight bias on an individual level, while still addressing structural change.

]]> Feminism and Its Associations with Weight Stigma, Body Image, and Disordered Eating: A Risk or Protective Factor? Brooke L. Bennett Allison F. Wagner Rebecca M. Puhl Alexis Lamere Janet D. Latner doi: 10.3390/obesities5020040 Obesities 2025-06-01 Obesities 2025-06-01 5 2 Article 40 10.3390/obesities5020040 https://www.mdpi.com/2673-4168/5/2/40 Obesities, Vol. 5, Pages 39: Nutritional Care Process in Hospitalized Patients with Obesity-Related Multimorbidity https://www.mdpi.com/2673-4168/5/2/39 Obesity-Related Multimorbidity (ORM) is understood as the group of secondary diseases caused by metabolic alterations that arise from obesity. Nowadays there is a growing incidence of people with ORM who seek health services. Since this condition substantially impacts nutritional status and therefore in the survival prognosis during the hospital stay, ORM represents a challenge for health professionals. This forces doctors to specify nutritional recommendations according to clinical characteristics in individuals with obesity and types of comorbidities. Therefore, the objective of this narrative review is to present the current evidence-based recommendations that support the hospital nutritional care process for individuals with ORM. It concludes that nutritional treatment is complex and gaps in the research regarding this population group still exist. Because there are no specific guidelines for nutritional screening tools, calculating total energy requirements (alternatives to indirect calorimetry), determining fluid, protein, and immunonutrient requirements, the use of parenteral nutrition in ORM with kidney, liver, and heart failure and sarcopenic obesity that should be addressed in the new literature. For now, the standard practice in these cases is to prioritize the problem to be treated according to the maximum clinical benefit. Despite this, it is established that the nutritional care process must be systematic to be clear and objective. This document is addressed to all healthcare professionals who make up the multidisciplinary nutritional support team. 2025-05-23 Obesities, Vol. 5, Pages 39: Nutritional Care Process in Hospitalized Patients with Obesity-Related Multimorbidity

Obesities doi: 10.3390/obesities5020039

Authors: Tania Rivera-Carranza Angélica León-Téllez Girón Claudia Mimiaga-Hernádez Adriana Aguilar-Vargas

Obesity-Related Multimorbidity (ORM) is understood as the group of secondary diseases caused by metabolic alterations that arise from obesity. Nowadays there is a growing incidence of people with ORM who seek health services. Since this condition substantially impacts nutritional status and therefore in the survival prognosis during the hospital stay, ORM represents a challenge for health professionals. This forces doctors to specify nutritional recommendations according to clinical characteristics in individuals with obesity and types of comorbidities. Therefore, the objective of this narrative review is to present the current evidence-based recommendations that support the hospital nutritional care process for individuals with ORM. It concludes that nutritional treatment is complex and gaps in the research regarding this population group still exist. Because there are no specific guidelines for nutritional screening tools, calculating total energy requirements (alternatives to indirect calorimetry), determining fluid, protein, and immunonutrient requirements, the use of parenteral nutrition in ORM with kidney, liver, and heart failure and sarcopenic obesity that should be addressed in the new literature. For now, the standard practice in these cases is to prioritize the problem to be treated according to the maximum clinical benefit. Despite this, it is established that the nutritional care process must be systematic to be clear and objective. This document is addressed to all healthcare professionals who make up the multidisciplinary nutritional support team.

]]> Nutritional Care Process in Hospitalized Patients with Obesity-Related Multimorbidity Tania Rivera-Carranza Angélica León-Téllez Girón Claudia Mimiaga-Hernádez Adriana Aguilar-Vargas doi: 10.3390/obesities5020039 Obesities 2025-05-23 Obesities 2025-05-23 5 2 Review 39 10.3390/obesities5020039 https://www.mdpi.com/2673-4168/5/2/39 Obesities, Vol. 5, Pages 38: Postpartum Depression: The Role of Gestational Weight and Adiposity, Prenatal Cortisol, Socioeconomic Resources, and Breastfeeding https://www.mdpi.com/2673-4168/5/2/38 This study examined the mediating role of prenatal cortisol on the relationship between gestational weight or adiposity and postpartum depression (PPD), while considering the moderating roles of breastfeeding (BF) or socioeconomic resources. We hypothesized that women with a higher pre-pregnancy body mass index (PPBMI) or a larger abdominal circumference would have elevated diurnal cortisol levels in late pregnancy, which would predict more PPD symptoms. Additionally, we hypothesized that BF and access to more socioeconomic resources would buffer the positive relationship between prenatal diurnal cortisol and PPD symptoms. We used longitudinal data from the Infant Development and Health Outcomes in Mothers Study, in which women self-reported PPBMI, BF frequency at 6 months, familial education, occupation, and income and completed the Edinburgh Postnatal Depression Scale. The abdominal circumference, cortisol area under the curve with respect to ground (AUCG), and cortisol awakening response (CAR) were measured. Higher breastfeeding frequency and greater socioeconomic resources were associated with fewer PPD symptoms. There were main and interactive associations of AUCG with BF frequency with PPD. Notably, higher cortisol levels were linked to more PPD symptoms among women with less frequent BF. Thus, BF may mitigate the relationship between prenatal stress and PPD, highlighting the importance of BF support in PPD prevention. 2025-05-21 Obesities, Vol. 5, Pages 38: Postpartum Depression: The Role of Gestational Weight and Adiposity, Prenatal Cortisol, Socioeconomic Resources, and Breastfeeding

Obesities doi: 10.3390/obesities5020038

Authors: Jasmin Kurien Nicki L. Aubuchon-Endsley

This study examined the mediating role of prenatal cortisol on the relationship between gestational weight or adiposity and postpartum depression (PPD), while considering the moderating roles of breastfeeding (BF) or socioeconomic resources. We hypothesized that women with a higher pre-pregnancy body mass index (PPBMI) or a larger abdominal circumference would have elevated diurnal cortisol levels in late pregnancy, which would predict more PPD symptoms. Additionally, we hypothesized that BF and access to more socioeconomic resources would buffer the positive relationship between prenatal diurnal cortisol and PPD symptoms. We used longitudinal data from the Infant Development and Health Outcomes in Mothers Study, in which women self-reported PPBMI, BF frequency at 6 months, familial education, occupation, and income and completed the Edinburgh Postnatal Depression Scale. The abdominal circumference, cortisol area under the curve with respect to ground (AUCG), and cortisol awakening response (CAR) were measured. Higher breastfeeding frequency and greater socioeconomic resources were associated with fewer PPD symptoms. There were main and interactive associations of AUCG with BF frequency with PPD. Notably, higher cortisol levels were linked to more PPD symptoms among women with less frequent BF. Thus, BF may mitigate the relationship between prenatal stress and PPD, highlighting the importance of BF support in PPD prevention.

]]> Postpartum Depression: The Role of Gestational Weight and Adiposity, Prenatal Cortisol, Socioeconomic Resources, and Breastfeeding Jasmin Kurien Nicki L. Aubuchon-Endsley doi: 10.3390/obesities5020038 Obesities 2025-05-21 Obesities 2025-05-21 5 2 Article 38 10.3390/obesities5020038 https://www.mdpi.com/2673-4168/5/2/38 Obesities, Vol. 5, Pages 37: Spatiotemporal Analysis of Obesity: The Case of Italian Regions https://www.mdpi.com/2673-4168/5/2/37 This study examines the spatial and temporal evolution of obesity among adults in Italian regions. In Italy, regional administrative areas are responsible for providing health services. Moreover, Italian regions present different socioeconomic conditions and health and nutritional habits. As a result, a regional analysis of the spatiotemporal evolution of obesity allows the identification of key areas for prevention and control, enabling the design of more targeted and effective interventions. In this study, the geographic clustering of obesity in Italy was explored by analyzing the local spatial autocorrelation of regional-level prevalence rates of adulthood obesity between 2010 and 2022, updating and expanding the existing literature. Data from the Health For All repository are analyzed to determine distribution patterns and trends, employing choropleth maps, Moran’s Index and Welch’s t-test. Gender inequalities have been underlined both in the spatial and temporal distribution. Results show that obesity exhibits spatial clustering, with greater severity in the south. During the period under analysis, obesity prevalence rates in Italy show a tendency to grow, with a sharp increase during the COVID-19 lockdown. 2025-05-21 Obesities, Vol. 5, Pages 37: Spatiotemporal Analysis of Obesity: The Case of Italian Regions

Obesities doi: 10.3390/obesities5020037

Authors: Elena Grimaccia Luciano Rota

This study examines the spatial and temporal evolution of obesity among adults in Italian regions. In Italy, regional administrative areas are responsible for providing health services. Moreover, Italian regions present different socioeconomic conditions and health and nutritional habits. As a result, a regional analysis of the spatiotemporal evolution of obesity allows the identification of key areas for prevention and control, enabling the design of more targeted and effective interventions. In this study, the geographic clustering of obesity in Italy was explored by analyzing the local spatial autocorrelation of regional-level prevalence rates of adulthood obesity between 2010 and 2022, updating and expanding the existing literature. Data from the Health For All repository are analyzed to determine distribution patterns and trends, employing choropleth maps, Moran’s Index and Welch’s t-test. Gender inequalities have been underlined both in the spatial and temporal distribution. Results show that obesity exhibits spatial clustering, with greater severity in the south. During the period under analysis, obesity prevalence rates in Italy show a tendency to grow, with a sharp increase during the COVID-19 lockdown.

]]> Spatiotemporal Analysis of Obesity: The Case of Italian Regions Elena Grimaccia Luciano Rota doi: 10.3390/obesities5020037 Obesities 2025-05-21 Obesities 2025-05-21 5 2 Article 37 10.3390/obesities5020037 https://www.mdpi.com/2673-4168/5/2/37 Obesities, Vol. 5, Pages 36: Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach https://www.mdpi.com/2673-4168/5/2/36 Excessive sugar consumption has been reported to be associated with various health issues such as obesity, diabetes, cardiovascular diseases, and dental problems. In the UK, effective strategies have been implemented to reduce sugar intake, including the Change4Life Sugar Smart campaign, product reformulation, traffic light labelling, portion control, and the Soft Drinks Industry Levy (SDIL). This review of empirical studies (n = 11) shows that product reformulation, especially in beverages and packaged foods, is effective, as consumers can prefer reduced-sugar alternatives when clearly labelled. The UK traffic light labelling scheme and portion control were also reported to help consumers make informed, healthier food choices. The SDIL, introduced in 2018, was also found to significantly lower sugary beverage consumption. While progress is evident, further nutrition education, public awareness, particularly for people with low socioeconomic status, and more comprehensive policies for long-term positive dietary behavioural shift are essential to limit diseases and conditions associated with high sugar consumption. Future research must evaluate the combined effects of these interventions and examine their long-term effectiveness across diverse population groups. 2025-05-17 Obesities, Vol. 5, Pages 36: Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach

Obesities doi: 10.3390/obesities5020036

Authors: Daniel Agboola Ogundijo Ayten Aylin Tas

Excessive sugar consumption has been reported to be associated with various health issues such as obesity, diabetes, cardiovascular diseases, and dental problems. In the UK, effective strategies have been implemented to reduce sugar intake, including the Change4Life Sugar Smart campaign, product reformulation, traffic light labelling, portion control, and the Soft Drinks Industry Levy (SDIL). This review of empirical studies (n = 11) shows that product reformulation, especially in beverages and packaged foods, is effective, as consumers can prefer reduced-sugar alternatives when clearly labelled. The UK traffic light labelling scheme and portion control were also reported to help consumers make informed, healthier food choices. The SDIL, introduced in 2018, was also found to significantly lower sugary beverage consumption. While progress is evident, further nutrition education, public awareness, particularly for people with low socioeconomic status, and more comprehensive policies for long-term positive dietary behavioural shift are essential to limit diseases and conditions associated with high sugar consumption. Future research must evaluate the combined effects of these interventions and examine their long-term effectiveness across diverse population groups.

]]> Strategies to Reduce the Consumption of Foods and Drinks with High Sugar Content in the UK: A Rapid Review Approach Daniel Agboola Ogundijo Ayten Aylin Tas doi: 10.3390/obesities5020036 Obesities 2025-05-17 Obesities 2025-05-17 5 2 Review 36 10.3390/obesities5020036 https://www.mdpi.com/2673-4168/5/2/36 Obesities, Vol. 5, Pages 35: Lycium barbarum for Health and Longevity: A Review of Its Biological Significance https://www.mdpi.com/2673-4168/5/2/35 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. 2025-05-16 Obesities, Vol. 5, Pages 35: Lycium barbarum for Health and Longevity: A Review of Its Biological Significance

Obesities doi: 10.3390/obesities5020035

Authors: Tao Zhang Elena-Alexandra Alexa Gavin Liu Alois Berisha Rhys Walsh Robbie Kelleher

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.

]]> Lycium barbarum for Health and Longevity: A Review of Its Biological Significance Tao Zhang Elena-Alexandra Alexa Gavin Liu Alois Berisha Rhys Walsh Robbie Kelleher doi: 10.3390/obesities5020035 Obesities 2025-05-16 Obesities 2025-05-16 5 2 Review 35 10.3390/obesities5020035 https://www.mdpi.com/2673-4168/5/2/35 Obesities, Vol. 5, Pages 34: Assessment of Body Mass Index for Obesity Diagnosis in the Mexican Population: A Cross-Sectional Analysis https://www.mdpi.com/2673-4168/5/2/34 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. 2025-05-13 Obesities, Vol. 5, Pages 34: Assessment of Body Mass Index for Obesity Diagnosis in the Mexican Population: A Cross-Sectional Analysis

Obesities doi: 10.3390/obesities5020034

Authors: Jorge Alejandro Ayala San Pedro Dylani Rosa Avila Salcedo Livia Magdalena Martínez Borja Elizabeth Castillo Montufar

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.

]]> Assessment of Body Mass Index for Obesity Diagnosis in the Mexican Population: A Cross-Sectional Analysis Jorge Alejandro Ayala San Pedro Dylani Rosa Avila Salcedo Livia Magdalena Martínez Borja Elizabeth Castillo Montufar doi: 10.3390/obesities5020034 Obesities 2025-05-13 Obesities 2025-05-13 5 2 Article 34 10.3390/obesities5020034 https://www.mdpi.com/2673-4168/5/2/34 Obesities, Vol. 5, Pages 33: Spatial Analysis of Metabolic Equivalents of Task Among Females in Urban and Rural Ghana https://www.mdpi.com/2673-4168/5/2/33 (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. 2025-05-03 Obesities, Vol. 5, Pages 33: Spatial Analysis of Metabolic Equivalents of Task Among Females in Urban and Rural Ghana

Obesities doi: 10.3390/obesities5020033

Authors: Sally Sonia Simmons

(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.

]]> Spatial Analysis of Metabolic Equivalents of Task Among Females in Urban and Rural Ghana Sally Sonia Simmons doi: 10.3390/obesities5020033 Obesities 2025-05-03 Obesities 2025-05-03 5 2 Article 33 10.3390/obesities5020033 https://www.mdpi.com/2673-4168/5/2/33 Obesities, Vol. 5, Pages 32: The Effects of High-Intensity Interval Training (HIIT) on Sleep Quality in Obese Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials https://www.mdpi.com/2673-4168/5/2/32 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. 2025-05-01 Obesities, Vol. 5, Pages 32: The Effects of High-Intensity Interval Training (HIIT) on Sleep Quality in Obese Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Obesities doi: 10.3390/obesities5020032

Authors: Kittibhum Kawinchotpaisan Charnsiri Segsarnviriya Phawit Norchai

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.

]]> The Effects of High-Intensity Interval Training (HIIT) on Sleep Quality in Obese Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Kittibhum Kawinchotpaisan Charnsiri Segsarnviriya Phawit Norchai doi: 10.3390/obesities5020032 Obesities 2025-05-01 Obesities 2025-05-01 5 2 Systematic Review 32 10.3390/obesities5020032 https://www.mdpi.com/2673-4168/5/2/32 Obesities, Vol. 5, Pages 31: Effects of Combining Shockwaves or Radiofrequency with Aerobic Exercise on Subcutaneous Adipose Tissue and Lipid Mobilization: A Randomized Controlled Trial https://www.mdpi.com/2673-4168/5/2/31 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. 2025-05-01 Obesities, Vol. 5, Pages 31: Effects of Combining Shockwaves or Radiofrequency with Aerobic Exercise on Subcutaneous Adipose Tissue and Lipid Mobilization: A Randomized Controlled Trial

Obesities doi: 10.3390/obesities5020031

Authors: Leila Marques Joana Neves Ana Pereira Ana Santiago Sara Troia Rui Vilarinho Maria Manuela Amorim Andreia Noites

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.

]]> Effects of Combining Shockwaves or Radiofrequency with Aerobic Exercise on Subcutaneous Adipose Tissue and Lipid Mobilization: A Randomized Controlled Trial Leila Marques Joana Neves Ana Pereira Ana Santiago Sara Troia Rui Vilarinho Maria Manuela Amorim Andreia Noites doi: 10.3390/obesities5020031 Obesities 2025-05-01 Obesities 2025-05-01 5 2 Article 31 10.3390/obesities5020031 https://www.mdpi.com/2673-4168/5/2/31 Obesities, Vol. 5, Pages 30: Alternative Dietary Strategies to Modulate Obesity and Improve Metabolic Health in Aging: A Comparative Narrative Review https://www.mdpi.com/2673-4168/5/2/30 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. 2025-05-01 Obesities, Vol. 5, Pages 30: Alternative Dietary Strategies to Modulate Obesity and Improve Metabolic Health in Aging: A Comparative Narrative Review

Obesities doi: 10.3390/obesities5020030

Authors: Antonio Fernando Murillo-Cancho David Lozano-Paniagua Bruno José Nievas-Soriano

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.

]]> Alternative Dietary Strategies to Modulate Obesity and Improve Metabolic Health in Aging: A Comparative Narrative Review Antonio Fernando Murillo-Cancho David Lozano-Paniagua Bruno José Nievas-Soriano doi: 10.3390/obesities5020030 Obesities 2025-05-01 Obesities 2025-05-01 5 2 Review 30 10.3390/obesities5020030 https://www.mdpi.com/2673-4168/5/2/30 Obesities, Vol. 5, Pages 29: Symptomatic Adverse Events and Quality of Life Related to Incretin-Based Medicines for Obesity: A Systematic Review Involving >400,000 Subjects https://www.mdpi.com/2673-4168/5/2/29 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. 2025-04-24 Obesities, Vol. 5, Pages 29: Symptomatic Adverse Events and Quality of Life Related to Incretin-Based Medicines for Obesity: A Systematic Review Involving >400,000 Subjects

Obesities doi: 10.3390/obesities5020029

Authors: Robert F. Kushner Odd Erik Johansen Krysmaru Araujo Torres Trà-Mi Phan Agnieszka Marczewska

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.

]]> Symptomatic Adverse Events and Quality of Life Related to Incretin-Based Medicines for Obesity: A Systematic Review Involving >400,000 Subjects Robert F. Kushner Odd Erik Johansen Krysmaru Araujo Torres Trà-Mi Phan Agnieszka Marczewska doi: 10.3390/obesities5020029 Obesities 2025-04-24 Obesities 2025-04-24 5 2 Systematic Review 29 10.3390/obesities5020029 https://www.mdpi.com/2673-4168/5/2/29 Obesities, Vol. 5, Pages 28: Anthropometric and Body Composition Changes After Bariatric Surgery—The Effect of Sex, Age, and Type of Surgery https://www.mdpi.com/2673-4168/5/2/28 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. 2025-04-22 Obesities, Vol. 5, Pages 28: Anthropometric and Body Composition Changes After Bariatric Surgery—The Effect of Sex, Age, and Type of Surgery

Obesities doi: 10.3390/obesities5020028

Authors: Rita Soares Guerra Cíntia Pinho-Reis Ana Sofia Sousa Joana Mendes Cláudia Silva

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.

]]> Anthropometric and Body Composition Changes After Bariatric Surgery—The Effect of Sex, Age, and Type of Surgery Rita Soares Guerra Cíntia Pinho-Reis Ana Sofia Sousa Joana Mendes Cláudia Silva doi: 10.3390/obesities5020028 Obesities 2025-04-22 Obesities 2025-04-22 5 2 Article 28 10.3390/obesities5020028 https://www.mdpi.com/2673-4168/5/2/28 Obesities, Vol. 5, Pages 27: Primary Care Practitioners’ Perspectives on the Utility of Metabolic Syndrome as a Diagnosis: A Qualitative Study https://www.mdpi.com/2673-4168/5/2/27 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. 2025-04-20 Obesities, Vol. 5, Pages 27: Primary Care Practitioners’ Perspectives on the Utility of Metabolic Syndrome as a Diagnosis: A Qualitative Study

Obesities doi: 10.3390/obesities5020027

Authors: Aniruddha Sheth Sandra C. Thompson Nahal Mavaddat

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.

]]> Primary Care Practitioners’ Perspectives on the Utility of Metabolic Syndrome as a Diagnosis: A Qualitative Study Aniruddha Sheth Sandra C. Thompson Nahal Mavaddat doi: 10.3390/obesities5020027 Obesities 2025-04-20 Obesities 2025-04-20 5 2 Article 27 10.3390/obesities5020027 https://www.mdpi.com/2673-4168/5/2/27 Obesities, Vol. 5, Pages 26: Efficacy and Safety of Tirzepatide for Weight Management in Non-Diabetic Obese Individuals: A Narrative Review https://www.mdpi.com/2673-4168/5/2/26 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. 2025-04-18 Obesities, Vol. 5, Pages 26: Efficacy and Safety of Tirzepatide for Weight Management in Non-Diabetic Obese Individuals: A Narrative Review

Obesities doi: 10.3390/obesities5020026

Authors: Mohammed Sallam Johan Snygg Sara El Ghandour Malik Sallam

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.

]]> Efficacy and Safety of Tirzepatide for Weight Management in Non-Diabetic Obese Individuals: A Narrative Review Mohammed Sallam Johan Snygg Sara El Ghandour Malik Sallam doi: 10.3390/obesities5020026 Obesities 2025-04-18 Obesities 2025-04-18 5 2 Review 26 10.3390/obesities5020026 https://www.mdpi.com/2673-4168/5/2/26 Obesities, Vol. 5, Pages 25: Poland and the World Trapped in Obesity: Causes, Implications, and Strategies for Prevention https://www.mdpi.com/2673-4168/5/2/25 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. 2025-04-17 Obesities, Vol. 5, Pages 25: Poland and the World Trapped in Obesity: Causes, Implications, and Strategies for Prevention

Obesities doi: 10.3390/obesities5020025

Authors: Agnieszka Orkusz Martyna Orkusz

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.

]]> Poland and the World Trapped in Obesity: Causes, Implications, and Strategies for Prevention Agnieszka Orkusz Martyna Orkusz doi: 10.3390/obesities5020025 Obesities 2025-04-17 Obesities 2025-04-17 5 2 Review 25 10.3390/obesities5020025 https://www.mdpi.com/2673-4168/5/2/25 Obesities, Vol. 5, Pages 24: Relationship of Nutritional Status and Physical Activity Level with Dynamic Postural Balance in Young Adults https://www.mdpi.com/2673-4168/5/2/24 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. 2025-04-17 Obesities, Vol. 5, Pages 24: Relationship of Nutritional Status and Physical Activity Level with Dynamic Postural Balance in Young Adults

Obesities doi: 10.3390/obesities5020024

Authors: Eduardo Guzmán-Muñoz Antonio Castillo-Paredes Felipe Montalva-Valenzuela Miguel Alarcón-Rivera Pablo Valdes-Badilla Jordan Hernandez-Martinez Héctor Fuentes-Barría

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.

]]> Relationship of Nutritional Status and Physical Activity Level with Dynamic Postural Balance in Young Adults Eduardo Guzmán-Muñoz Antonio Castillo-Paredes Felipe Montalva-Valenzuela Miguel Alarcón-Rivera Pablo Valdes-Badilla Jordan Hernandez-Martinez Héctor Fuentes-Barría doi: 10.3390/obesities5020024 Obesities 2025-04-17 Obesities 2025-04-17 5 2 Article 24 10.3390/obesities5020024 https://www.mdpi.com/2673-4168/5/2/24