Search Results (126)

Obesity is a growing public health concern linked to poor dietary habits, physical inactivity, and metabolic disturbances, which can be evaluated using complementary laboratory tests. Among pharmacological interventions, semaglutide, a GLP-1 receptor agonist, has shown promise by acting on the central nervous system to reduce appetite and stimulate insulin secretion, thereby improving the lipid profile and reducing inflammation biomarkers. This review focused on changes in lipid parameters and C-reactive protein (CRP) levels in overweight or obese individuals treated with semaglutide, based on phase 3 studies from the STEP program (“Semaglutide Treatment Effect in People with Obesity”). The STEP clinical trial program was conducted across 36 countries, reflecting a broad and diverse geographic representation. Key findings include significant reductions between placebo vs. semaglutide in body weight (−1.3 vs. −13.0 Kg), body mass index (−0.69 vs. −4.72 kg/m²), and waist circumference (−2.79 × −11.81 cm). Additionally, there were notable decreases in triglycerides (−0.67 vs. −20.89%), VLDL-C (−0.99 vs. 20.82%), and CRP levels (−15.45 vs. −55.55%). These changes reflect improvements in both inflammatory and metabolic markers. The observed benefits suggest that semaglutide may contribute to reducing comorbidities associated with metabolic syndrome and to the prevention of cardiovascular disease. Current evidence also supports its potential role in individualized treatment strategies based on patients’ clinical and biochemical profiles. However, despite these promising findings, further long-term studies are required to confirm the efficacy and safety of semaglutide across diverse populations. Full article

Background/Objectives: Concussions occur across all sports globally; however, inconsistent symptom recognition continues to challenge diagnosis, management, and recovery. Although concussion effects extend beyond neurological dysfunction, gastrointestinal (GI) symptoms remain insufficiently captured within current assessment frameworks and may influence athletes’ fuelling choices and food tolerance during recovery. This study aimed to describe the prevalence and patterns of GI symptoms reported among athletes with a history of concussion and to explore whether symptom prevalence and burden differed by sex and country. Methods: A total of 401 adult athletes (225 males; mean age 32.4 ± 11.3 years) with a history of concussion were recruited from a multinational cohort (n = 123) and a US community rugby cohort (n = 278). Participants completed online surveys assessing concussion history, post-concussion symptoms (RPQ or SCAT-6), and GI-specific symptoms. Data were stratified by sex and country and analysed descriptively and comparatively. Results: Overall, 62.1% of athletes reported ≥1 GI symptom, with most reporting 1–5 symptoms (79.9%). The most frequent symptoms were nausea/vomiting (74.3%) and loss of/poor appetite (56.6%), followed by diarrhoea, abdominal pain/discomfort, and flatulence. Although GI symptom prevalence was higher in females (65.9% vs. 59.1%), no significant sex differences were observed (all p > 0.05). GI symptom burden varied by country (p < 0.001), with higher prevalence among Irish than US athletes (85.9% vs. 51.2%); however, these analyses were exploratory and unadjusted. RPQ and SCAT captured symptoms across somatic, cognitive, emotional, and sleep domains, however GI symptoms were underrepresented, with nausea/vomiting more frequently reported on RPQ/SCAT items (51.4%) than on GI-specific items (46.1%). Conclusions: GI symptoms were common following concussion, with variation by country and no statistically significant differences by sex. Findings indicate that concussion assessment tools (RPQ/SCAT) underrepresent the breadth of GI symptoms. Greater attention to GI assessment in concussion care is warranted. Incorporating simple GI screening alongside timely nutrition support may represent feasible additions to multidisciplinary, athlete-centred care pathways. Prospective studies are needed to clarify the clinical relevance of these findings and evaluate nutrition-related strategies. Full article

Advanced gastric and gastroesophageal junction (gastric/GOJ) adenocarcinomas have poor outcomes, and the benefit of immune checkpoint inhibitors (CPIs) remains limited. Bavituximab is a phosphatidylserine-targeting monoclonal antibody that modulates the immune and vascular tumour microenvironment. This Phase 2, open-label, multinational study evaluated bavituximab plus pembrolizumab in previously treated advanced gastric/GOJ. Patients were stratified into CPI-naïve (n = 61) and CPI-relapse (n = 19) cohorts. Bavituximab (3 mg/kg weekly) was combined with pembrolizumab (200 mg every 3 weeks) until disease progression or unacceptable toxicity. Primary endpoints included the safety and objective response rate (ORR) per RECIST 1.1. Secondary endpoints included the disease control rate (DCR), progression-free survival, overall survival, and exploratory biomarker analyses using the Xerna TME Panel and the neutrophil-to-lymphocyte ratio (NLR). No dose-limiting toxicities were observed. The most common treatment-emergent adverse events were fatigue (32.5%), constipation (31.3%), and decreased appetite (31.3%). The ORR was 13.1% in CPI-naïve and 5.3% in CPI-relapse patients; the median duration of response was 12.5 months in the CPI-naïve cohort. The DCR was 39.3% and 52.6% respectively. Higher ORRs were observed in patients with immune-high (B+) subtypes (21.9%), NLR < 4 (17.9%) and B+/NLR < 4 (33%). Bavituximab plus pembrolizumab was well tolerated but showed modest activity, with greater benefit in biomarker-defined subgroups, supporting the biomarker-driven development of tumour microenvironment-targeting combinations in advanced gastric/GOJ adenocarcinomas. NCT04099641. Full article

Background: The Older Americans Act (OAA) home-delivered and congregate meal programs and related nutrition services are the largest federal programs in the United States (U.S.) to reduce malnutrition (undernutrition) among community-dwelling older adults. However, the prevalence of undernutrition has received little attention in the OAA programs, while many studies report the prevalence of overweight and obesity. Objective: We documented undernutrition risk prevalence estimates post-COVID-19 in a 2023 nationally representative survey of OAA participants in the U.S. Undernutrition risk prevalence may have been elevated among those surveyed previously in 2022 because data were collected during the COVID-19 pandemic. Methods: Data were obtained from the 2023 National Survey of Older Americans Act Participants (NSOAAP) (n = 4159); a cross-sectional survey of OAA participants randomly selected from a stratified sample of Area Agencies on Aging throughout the U.S. The NSOAAP included measurement of undernutrition risk, the main outcome of interest, using the Malnutrition Screening Tool (MST) that queried self-reports of unintended weight loss and decreased food intake due to poor appetite. MST scores ≥ 2 were defined as indicating undernutrition risk. Data were reported using confidence intervals. Results: In 2023, nearly 1 in 5 NSOAAP respondents were at undernutrition risk; 9.9% (95% CI 7.3–13.0%) of congregate meal participants, 20.8% (95% CI 18.3–23.5%) of home-delivered meal participants, and 21.3% (95% CI 16.7–26.4%) of participants in OAA non-nutrition programs (transportation, case management, or homemaker services). Participants in different OAA program types also differed in many demographic and health-related characteristics. Conclusions: Since undernutrition risk is neither a definitive diagnosis of undernutrition nor its causes, it must be followed up by further nutrition assessment. Full article

Post-exercise appetite loss may interfere with adequate recovery nutrition in athletes; however, the substantial inter-individual variability in appetite responses remains insufficiently understood. This exploratory cross-sectional study investigated lifestyle- and health-related factors associated with post-exercise appetite loss in 35 female university athletes. Appetite loss was assessed as a self-reported binary outcome (often, sometimes/never). Associations with subjective sleep quality and other lifestyle-related variables were examined using contingency analysis, followed by exploratory logistic regression. Post-exercise appetite loss was reported by 74.3% of participants and did not differ across sports disciplines, indicating that the sport type alone did not explain the observed variability. Poor/fair subjective sleep quality was associated with appetite loss (OR = 11.6, 95% CI: 1.9–73.6) and remained associated in the multivariate model. Other lifestyle-related variables were not independently associated. These findings imply a potential connection linking post-exercise appetite responses in female university athletes to broader lifestyle-related factors, particularly subjective sleep quality, rather than exercise characteristics alone. Monitoring sleep quality may therefore help identify athletes who may be at risk of insufficient post-exercise energy intake and compromised recovery. Further studies with larger samples and longitudinal designs are needed to clarify these relationships. Full article

Background: Poly(ADP-ribose) polymerase inhibitor (PARPi) treatment in ovarian cancer patients after first-line chemotherapy and following the response to platinum-based chemotherapy at relapse is associated with survival benefits. Maintenance therapies can be administered over extended periods, making treatment tolerability assessment essential in optimizing patient outcomes. This cohort study aimed to evaluate the agreement between physician and patient reporting of PARP inhibitor-related toxicities and the rate of underestimation of each symptom considered. Methods: Patients treated with PARPis in the first-line or recurrent setting were included. A specific Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) questionnaire was generated and administered to the cohort. For each toxicity, agreement between patients and physicians was assessed using Cohen’s kappa and Gwet’s AC1; in addition, the rate of toxicity under-reporting by physicians was calculated. Results: Seventy-seven ovarian cancer patients were included; 39 (50.6%) received PARPis in the first-line setting, while 38 (49.4%) were treated for recurrence. Cohen’s kappa values for agreement between patients and physicians across 12 reported toxicities ranged from 0 to 0.15, indicating poor agreement (κ < 0.20) for all assessed toxicities, with the lowest levels of agreement for decreased appetite (κ = 0), rash (κ = 0.02), headache (κ = 0.00), arthralgia (κ = 0.03), insomnia (κ = 0.03), and fatigue (κ = 0.04). When agreement was assessed using Gwet’s AC1, agreement remained poor to moderate for the majority of the symptoms evaluated. Physician under-reporting rates were higher for nausea (51.9%), rash (57.1%), headache (49.3%), arthralgia (70.2%), insomnia (48.1%), and fatigue (67.5%). Conclusions: Our results underscore the importance of systematically integrating patient-reported outcomes into clinical practice, including in maintenance settings, to ensure an accurate assessment of treatment-related toxicities. Full article

Prader–Willi (PWS) and Angelman (AS) syndromes were the first examples in humans with errors in genomic imprinting, usually from de novo 15q11-q13 deletions of different parent origin (paternal in PWS and maternal in AS). Dozens of genes and transcripts are found in the 15q11-q13 region, and may play a role in PWS, specifically paternally expressed SNURF-SNRPN and MAGEL2 genes, while AS is due to the maternally expressed UBE3A gene. These three causative genes, including their encoding proteins, were targeted. This review article summarizes and illustrates the current understanding and cause of both PWS and AS using strategies to include the literature sources of key words and searchable web-based programs with databases for integrated gene and protein interactions, biological processes, and molecular mechanisms available for the two imprinting disorders. The SNURF-SNRPN gene is key in developing complex spliceosomal snRNP assemblies required for mRNA processing, cellular events, splicing, and binding required for detailed protein production and variation, neurodevelopment, immunodeficiency, and cell migration. The MAGEL2 gene is involved with the regulation of retrograde transport and promotion of endosomal assembly, oxytocin and reproduction, as well as circadian rhythm, transcriptional activity control, and appetite. The UBE3A gene encodes a key enzyme for the ubiquitin protein degradation system, apoptosis, tumor suppression, cell adhesion, and targeting proteins for degradation, autophagy, signaling pathways, and circadian rhythm. PWS is characterized early with infantile hypotonia, a poor suck, and failure to thrive with hypogenitalism/hypogonadism. Later, growth and other hormone deficiencies, developmental delays, and behavioral problems are noted with hyperphagia and morbid obesity, if not externally controlled. AS is characterized by seizures, lack of speech, severe learning disabilities, inappropriate laughter, and ataxia. This review captures the clinical presentation, natural history, causes with genetics, mechanisms, and description of established laboratory testing for genetic confirmation of each disorder. Three separate searchable web-based programs and databases that included information from the updated literature and other sources were used to identify and examine integrated genetic findings with predicted gene and protein interactions, molecular mechanisms and functions, biological processes, pathways, and gene-disease associations for candidate or causative genes per disorder. The natural history, review of pathophysiology, clinical presentation, genetics, and genetic-phenotypic findings were described along with computational biology, molecular mechanisms, genetic testing approaches, and status for each disorder, management and treatment options, clinical trial experiences, and future strategies. Conclusions and limitations were discussed to improve understanding, clinical care, genetics, diagnostic protocols, therapeutic agents, and genetic counseling for those with these genomic imprinting disorders. Full article

Background/Objectives: Autosomal dominant polycystic kidney disease (ADPKD) is a major cause of end-stage kidney disease (ESKD), accounting for approximately 5–10% of patients receiving dialysis worldwide. The large and numerous cysts in the liver and kidneys cause abdominal distention and poor appetite. Previous studies showed that renal arterial embolization (RAE) reduces total kidney volume (TKV), increases appetite, and improves quality of life. This article aims to evaluate the efficacy of RAE in increasing psoas muscle (PM) and paraspinal muscle (PS) mass in patients with polycystic kidney disease. Methods: A retrospective study was conducted from May 2016 to December 2020. Thirty-five patients with PKD and ESKD who received RAE were enrolled. The clinical data, including age, sex, body weight, abdominal circumference, and laboratory results, including albumin, creatinine, estimated glomerular filtration rate, and dialysis vintage, were collected. TKV was calculated with the ellipsoid formula method, and muscle mass was measured with bilateral PM and PS areas at the third lumbar level. The associated clinical, laboratory, and imaging data were compared before and after RAE. Results: There were 19 females and 16 males with a mean age of 59.9 for the final analysis. There were significant changes between baseline and 3-month, 6-month, 12-month after RAE, such as a decrease in TKV (4684 ± 3361 vs. 4079 ± 3456, 3675 ± 3401, 2459 ± 1706 mL, all p < 0.001), an increase in the PM area (12.6 ± 5.8 vs. 13.3 ± 5.7, 14.7 ± 6.9, 14.3 ± 7.1 cm², all p < 0.05), but no difference in body weight, body mass index, albumin, hemoglobin, creatinine, or estimated glomerular filtration rate. The increase in the PM and PS was more obvious in the sarcopenic group than in the non-sarcopenic group in the 12-month follow-up (p = 0.001 and 0.016 vs. p = 0.205 and 0.259). Conclusions: RAE effectively reduces TKV, increases PM and PS mass, and serves as a candidate to reverse muscle loss in patients with PKD. Full article

Prader–Willi syndrome (PWS) is a rare, multisymptomatic genetic disorder caused by the absence or dysfunction of specific genes on chromosome 15. The genetic abnormality is anticipated to cause a dysfunction of the hypothalamus, which is also central in the regulation of the autonomic nervous system (ANS). Typical symptoms of PWS indicating a hypothalamic dysfunction include muscular hypotonia, poor growth, short stature, and feeding difficulties in infancy, which in early childhood are replaced by hyperphagia, leading to a high risk of obesity. Other characteristics, such as sleep difficulties, altered pain perception, delayed gastric emptying and constipation, blood pressure irregularities and dysregulated stress response, altered temperature regulation, delayed pupillary reaction, and urine retention and incontinence, all indicate a dysfunction of ANS. The ANS is usually divided into three parts: the sympathetic nervous system (SNS), which activates the fight-or-flight response during stress; the parasympathetic nervous system (PNS), which promotes calm and digestion; and the independent enteric nervous system (ENS), which regulates the gastrointestinal tract. Noradrenaline is the main neurotransmitter for the SNS, and acetylcholine for the PNS, while the ENS is regulated mainly by acetylcholine and serotonin. However, the ENS is modulated by both the SNS and the PNS, as well as many neuropeptides. Peptides regulating behavior, metabolism, appetite, and satiety have been extensively studied in PWS. However, studies of the role of neuropeptides in regulating other autonomic functions are limited and remain poorly understood. This review aims to synthesize current evidence from both animal models and human studies to explore potential mechanisms by which neuropeptides may contribute to autonomic dysfunction in individuals with PWS. Full article

Background and Objectives: Japan’s aging population faces growing challenges related to oral frailty, a condition characterized by the decline of oral function associated with physical and nutritional deterioration. Impaired oral function contributes to reduced chewing, swallowing, and saliva secretion, leading to poor appetite and frailty progression. Ninjin’yoeito (NYT), a traditional Kampo formula, has been clinically used to improve systemic weakness and oral symptoms. This study aimed to evaluate the efficacy and safety of NYT in improving oral health among elderly individuals with impaired oral function. Materials and Methods: In this open-label prospective study, patients received NYT daily for 12 weeks. Assessments included oral symptom scores, mucosal moisture, repetitive saliva swallowing tests (RSST), gustatory function by visual analogue scale (VAS), an 11-item oral questionnaire, and immune profiling by flow cytometry. Safety was assessed through hematological and biochemical tests. Results: Symptom scores decreased from 8.27 at baseline to 3.64 at 12 weeks (p = 0.006), while oral condition scores improved from 5.09 to 1.36 (p = 0.006). Mucosal moisture increased (25.1 to 28.1, p = 0.03), and RSST frequency improved (2.18 to 4.55, p = 0.046). Questionnaire scores declined from 5.1 to 2.0 (p < 0.001). VAS-taste was unchanged overall (p = 0.21) but improved in low baseline patients. Laboratory findings showed no adverse changes, with favorable lipid trends. Immune analysis revealed a decline in NKG2D expression (p = 0.02), whereas other activating and inhibitory markers remained stable. Conclusions: NYT was well tolerated and associated with gradual improvements in oral and physical symptoms among elderly individuals with impaired oral function. These findings provide preliminary evidence supporting the feasibility of Kampo-based approaches for maintaining oral health in aging populations and warrant further validation in larger controlled trials. Full article

Background/Objectives: Diffuse large B-cell lymphoma (DLBCL) exhibits substantial clinical heterogeneity and poor prognosis in relapsed/refractory (R/R) settings. PRO-MIND is a prospective, multicenter real-world study evaluating tafasitamab–lenalidomide followed by tafasitamab monotherapy in patients with transplant-ineligible R/R DLBCL in Italy. This ad hoc, cross-sectional, baseline analysis aimed to characterize health-related quality of life (HRQoL) and symptom burden before tafasitamab–lenalidomide initiation in the PRO-MIND cohort. Methods: Thirty-eight patients across 30 centers completed the EORTC QLQ-C30 and QLQ-NHL-HG29 questionnaires at pretreatment baseline, prior to starting tafasitamab–lenalidomide. EORTC QLQ-C30 scores (0–100) were compared with age-specific normative values for the Italian general population using Welch’s t-test. Differences of ≥5 points were considered clinically meaningful and ≥10 points clearly clinically important. Effect sizes (Cohen’s d) were calculated to complement p-values for between-group comparisons. Results: Compared with normative data, the PRO-MIND cohort had significantly lower EORTC QLQ-C30 functioning scores for physical (Δ 12.7, p = 0.0135), role (Δ 16.1, p = 0.0168), social (Δ 15.2, p = 0.0019), and cognitive (Δ 8.5, p = 0.0460) functioning. Symptom scales revealed worse fatigue (Δ 14.8, p = 0.0097), insomnia (Δ 13.9, p = 0.0291), appetite loss (Δ 9.4, p = 0.0435), and pain (Δ 8.7, p = 0.0430) in the PRO-MIND cohort versus normative data, with effect sizes in the small-to-moderate range. EORTC QLQ-NHL-HG29 scores indicated a high prevalence of concerns about future health (84.2%), disease recurrence (81.6%), and dependency (78.9%), as well as physical symptoms, including lack of energy (71.1%), sleep difficulties (63.2%), and pain or discomfort (60.5%). Conclusions: This cross-sectional, baseline-only analysis of the PRO-MIND real-world cohort showed that patients with transplant-ineligible R/R DLBCL scheduled to receive tafasitamab–lenalidomide already had pronounced impairments in physical, role, social, and cognitive functioning, along with substantial fatigue, insomnia, pain, appetite loss, and psychological concerns. These baseline benchmarks underscore the importance of systematic HRQoL assessment and targeted supportive interventions focusing on these domains before and during treatment. Future longitudinal PRO-MIND analyses will complement these findings by describing how HRQoL evolves after tafasitamab–lenalidomide initiation. Full article

Background: Daily energy intake from snacking behaviors has increased over the past few decades, during which the prevalence of obesity and metabolic syndrome has risen to epidemic proportions. There remains considerable room for improvement in the overall quality of dietary intakes of the U.S. population when compared to national recommendations. Food cravings may contribute to the types of snacks chosen for consumption, and thus, the frequency of foods and food groups consumed, and the overall nutritional quality of the diet. Methods: Eighty-four young (28.5 ± 4.3 years) adults with at least one metabolic syndrome risk factor participated in a parallel-arm single-blind randomized trial designed to compare effects of consuming a mix of tree nuts versus typical high-carbohydrate food items as between-meal snacks for 16 weeks. Cravings for 28 common foods via the Food Craving Inventory, short-term dietary intakes via 24 h multi-pass methodology, food group frequency via the Rapid Eating Assessment for Participants, usual hunger and fullness via visual analog scales, appetite-regulating hormones, and diet quality via the Healthy Eating Index—2015 were measured at baseline and end of study. Results: Participants in the TNsnack group had significant decreases in cravings for high sweet items and fast-food items, which were associated with decreased frequency of desserts and salty foods along with increased intake of higher protein items. In contrast, no significant reductions in food cravings or preference for sweets were observed in the CHOsnack group. Decreased cravings for sweets by TNsnack participants were associated with increased total GLP-1 levels: cake (r = −0.35, p = 0.03), brownies (r = −0.44, p = 0.02), candy (r = −0.36, p = 0.03) and ice cream (r = −0.33, p = 0.04). Overall, the total diet quality score improved by 19% among TNsnack participants. Conclusions: Replacing more typical between-meal snacks with tree nuts may reduce food cravings, particularly for sweeter food items that are likely to be nutrient poor and energy dense. By reducing cravings and frequency of intake, consuming tree nuts as snacks could facilitate having a higher quality, more nutrient-dense diet and mitigate potential negative effects of snacking on metabolic health in young adults. Full article

Background: Post-traumatic stress disorder (PTSD) is a mental disorder that can develop after experiencing or witnessing a traumatic event. Dysfunction of the hypothalamic–pituitary–adrenal (HPA) axis and alterations in neurotransmitters (gamma-aminobutyric acid (GABA) and glutamate) are the main pathologies of PTSD. In particular, altered GABAergic neurotransmission and reduced GABA activity are linked to PTSD. Given the low efficacy and side effects of serotonin reuptake inhibitors—the most common treatment for PTSD—a safer and more effective treatment is urgently needed. Bojungikgi-tang (BJIGT) is well-known herbal prescription in East Asia, which used to boost immunity and to alleviated symptoms such as chronic fatigue, poor appetite, and indigestion. However, its role in PTSD remains largely unexamined. This study aimed to investigate the effects of BJIGT in single-prolonged stress with shock (SPSS)-induced PTSD male mice for 2 weeks. Methods: To assess PTSD-like behaviors, we conducted open field, forced swimming, Y-maze, and contextual fear conditioning tests. To investigate the underlying mechanisms, we performed ELISA, Western blot, and immunohistochemistry. Results: BJIGT significantly ameliorated PTSD-like behaviors, including emotional and cognitive decline. Additionally, it restored serum corticosterone levels, regulated neuronal functions (c-Fos, DCX, and Prox1), and GABAergic neurotransmission-related factors (vGAT, GAD67, and parvalbumin) in the hippocampus of PTSD mice. Notably, in SPSS-induced PTSD mice, BJIGT effectively ameliorated pathological changes by modulating JNK-CaMKII and Pin1–β-catenin intracellular signaling. Conclusions: These findings revealed that BJIGT effectively improved PTSD-like emotional and cognitive decline by regulating the HPA axis and GABAergic neurotransmission in SPSS-induced PTSD mice, thereby promising to be an effective strategy for the treatment of PTSD. Full article

Background: Patients with hematologic malignancy (HM) experience high symptom burden (SB) and diminished quality of life (QOL). While early palliative care (EPC) benefits solid tumors, its impact in HM remains uncertain. Objectives: To systematically review the effects of EPC on patient-centered outcomes in individuals with HM. Methods: MEDLINE, Web of Science, Cochrane Library, and Scopus were searched for English-language articles published between 2020 and 2024. Eligible studies included adults with advanced HM receiving EPC compared with usual care, reporting outcomes on SB, QOL, place of death (POD), healthcare costs (HCCs), or healthcare utilization (HCU). All original study designs were considered. Critical appraisal was performed, and results were synthesized narratively. The review was registered in PROSPERO (CRD420251019687). Results: Twelve studies were included, most of high quality (n = 10) and mainly conducted in America and Europe. Collectively, they enrolled 42,053 participants, largely with advanced disease, poor performance status, or limited prognosis. EPC consistently improved SB, particularly pain, appetite, and functional well-being, although results for anxiety and depression were inconsistent. Findings for QOL were mixed. EPC was associated with higher likelihood of home or hospice death. One study demonstrated substantial cost savings with home-based EPC. Across several studies, EPC was linked to lower HCU, including fewer transfusions, reduced chemotherapy near the end-of-life, and fewer aggressive interventions, hospitalizations, and intensive care admissions. Conclusions: EPC improves SB, influences POD, and reduces HCCs and HCU in HM. Evidence for QOL and psychological outcomes remains inconclusive. Further high-quality research is required to consolidate these findings. Full article

Obesity is a multifaceted disorder influenced by various factors, with heredity being a significant contributor. Bariatric surgery is the most effective long-term intervention for morbid obesity and associated comorbidities, while outcomes vary significantly across individuals. Recent studies indicate that genetic and molecular determinants, particularly alterations in the leptin–melanocortin signalling pathway involving the fat mass and obesity-associated gene (FTO), pro-opiomelanocortin (POMC), melanocortin 4 receptor (MC4R), leptin (LEP), and leptin receptor (LEPR), influence the efficacy of weight loss and metabolic adaptations post-surgery. This narrative review consolidates evidence from peer-reviewed papers available in PubMed and Scopus until July 2025. The emphasis was on novel research and systematic reviews examining genetic polymorphisms, gene–environment interactions, and outcomes following bariatric procedures such as Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Recent research emphasised the integration of genetic screening and precision medicine models into clinical bariatric workflows. Variants in FTO (e.g., rs9939609), MC4R (e.g., rs17782313), LEPR, and POMC are associated with diminished weight loss post-surgery, an increased likelihood of weight regain, and reduced metabolic enhancement. Patients with bi-allelic mutations in MC4R, POMC, or LEPR exhibited poor long-term outcomes despite receiving effective physical interventions. Furthermore, genes regulating mitochondrial metabolism (such as PGC1A), adipokine signalling (such as ADIPOQ), and glucose regulation (such as GLP1R) have been demonstrated to influence the body’s response to sugar and the extent of weight gain or loss. Two recent systematic reviews elucidate that candidate gene investigations are beneficial; however, larger genome-wide association studies (GWAS) and machine learning techniques are necessary to enhance predictive accuracy. Integrating genetic and molecular screening with bariatric surgery planning possesses significant therapeutic potential. Genotyping can assist in patient selection, procedural decisions, and medication additions, particularly for those with variants that influence appetite regulation or metabolic flexibility. Advancements in precision medicine, including the integration of polygenic risk scores, omics-based profiling, and artificial intelligence, will enhance the customisation of surgical interventions and extend the lifespan of individuals with severe obesity. The epigenetic regulators of energy balance DNA methylation, histone changes, and microRNAs that may affect individual differences in weight-loss patterns after bariatric surgery are also briefly contextualised. We discuss the concept that epigenetic modulation of gene expression, mediated by microRNAs in response to food and exercise, may account for variations in metabolic outcomes post-surgery. Full article