Obesity Reviews最新文献

In the UK, over 25% of adults are living with obesity, with disproportionately higher rates among Black adults (35%) and those in the most deprived areas (36%). Obesity is linked to increased comorbidity, mortality, stigma, and substantial annual health costs exceeding £11.4 billion. Behavioral weight-management programmes are the primary intervention recommended for obesity treatment, yet they demonstrate limited effectiveness, inadequate long-term support, a lack of personalized care and poor cultural relevance. Participatory approaches, that is, bottom-up strategies engaging communities, are increasingly applied in public health to address social determinants and reduce disparities. Individuals supported to manage their health and access care are considered “empowered”; however, this concept remains ambiguous, lacking clear definition and consistent application. Although global policy promotes empowerment to promote individual health, including weight-management, no review has explored its role within obesity and weight-management programmes. This scoping review examined how empowerment has been defined and implemented across behavioral weight-management programmes. Eleven studies were identified published between 2004 and 2023, revealing poor consensus in their theoretical foundations, definitions, and practical applications of empowerment, with no UK-based studies. To support conceptual clarity, studies definitions and empowerment-based processes were consolidated. Further research is needed in UK settings to help define empowerment in this context and to enable effective translation between research, practice, and policy.

Background: Obesity's global rise has outpaced the effectiveness of "one-size-fits-all" prevention and treatment strategies. The promise of precision medicine lies in addressing the etiological and biological diversity of obesity and transforming it into actionable endotypes.

Objectives: In a narrative review, we analyze "obesityomics," looking at the contributions each omics layer makes to understanding and managing obesity. The areas we evaluate are genomics (heritability, polygenic risk, and monogenic forms), epigenomics (development and environment imprinting), transcriptomics (tissue-specific programs of adipose, liver, muscle, and hypothalamus), proteomics (signaling networks and adipokines), metabolomics and lipidomics (fuel partitioning, lipotoxicity, and metabolic inflection points), and microbiome science (metabolites, host-microbe interactions, and microbial ecology). Our domain-by-domain (single-omics) approach demonstrates how disease taxonomy, causal pathways, and biomarkers can be refined and targeted therapeutically.

Discussion: We argue that "obesityomics" is a pragmatic approach to aligning omics modalities to the right questions at the right time, not a wholesale merger of datasets. Artificial intelligence (AI)-including machine learning and deep learning-should be used in conjunction with quality control, feature selection, modest data integration, and obesity intervention prediction. Among the key challenges in managing sensitive multilayer data are harmonization, standardization, reproducibility, equitable representation, and governance. The translation priorities include prospective studies related to patient-centered outcomes, biomarker panels that are clinic-ready, interoperability standards, and cost-effectiveness evaluations.

Conclusion: The review maps concrete steps to assist people with obesity in making better choices by identifying what each omics domain excels at and introducing a brief AI perspective.

The development of GLP-1 and GIP analogs has been a significant breakthrough in type 2 diabetes and obesity pharmacotherapy. However, individual responses to these medications can vary widely. This systematic review examines factors associated with low or no weight loss response to GLP-1 and GIP analogs. Key predictors of poor response include higher baseline body weight, BMI, HbA1c, and insulin resistance. Genetic factors, such as variants in the GLP1R gene, may also influence treatment outcomes. Metabolic health status, particularly glycemic control and insulin sensitivity, plays a crucial role in determining weight loss efficacy. Adherence to medication regimens is strongly associated with treatment success, with each additional month of treatment linked to greater weight loss. Lifestyle factors, including dietary habits and physical activity, can modulate responses to these medications. Emerging evidence suggests that gut microbiome composition may mediate weight loss outcomes. Demographic factors such as male sex and older age are associated with lower weight loss responses. Understanding these predictors is essential for optimizing treatment strategies, setting realistic expectations, and moving towards a precision medicine approach in obesity care. Further research is needed to validate these findings in diverse populations and develop practical tools for clinical decision-making.

Maternal overnutrition during pregnancy predisposes children to increased adiposity later in life. This systematic review and meta-analysis examined how this association persists into adulthood and whether it differs by sex. MEDLINE, EMBASE, Scopus, and CENTRAL were searched for human studies published in English before May 2025. From 9191 screened records, 29 studies (430,764 mother–offspring pairs) provided quantitative data on the link between maternal pre-pregnancy body mass index (ppBMI) or gestational weight gain (GWG) and adiposity in adult offspring. The meta-analysis found significant positive associations between maternal ppBMI and offspring BMI, body fat percentage, or waist circumference. Each 1 kg/m² increase in maternal ppBMI was linked to a 0.4 kg/m² higher BMI and 0.35% more body fat in offspring. Maternal overweight/obesity predicted significantly higher offspring BMI or waist circumference, especially in females. Excessive GWG increased the odds of overweight/obesity in the offspring by 35% compared with adequate GWG. This correlation was stronger in early midlife (mean age 30–45) than in young adults. In early midlife offspring, each additional kilogram of GWG was linked to a 0.14 kg/m² higher BMI, independent of ppBMI. These findings underscore the importance of nutritional interventions before and during pregnancy to reduce obesity risk in adulthood.

GLP-1 receptor agonist medications have the potential to promote marked weight loss, but maximal and sustained benefit may be compromised by poor compliance and cessation of use. Development of next-generation medications that address current obstacles to effective use and development of effective adjunct treatments will benefit from better characterization of their mechanisms of action. This narrative review critically assesses eight purported mechanisms including modulation of appetite, chemosensory function, cravings/aversions, food noise, gastric emptying, the microbiome, incretin activity, and energy expenditure. Current evidence does not support a single dominant mechanism; a combination of subtle effects may underlie the efficacy of these medications. However, as experience with these medications and methods to assess their effects grows, it should be possible to better determine the relative importance of these and possibly other mechanisms.