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Summary Objective Methods Results Conclusion The purpose of this study is to utilize network meta‐analysis (NMA) to synthesize relevant randomized controlled trials (RCTs) and evaluate the most effective intermittent fasting (IF) combined with exercise interventions for weight loss.This study searched five databases up until April 2024, obtaining RCTs that investigated the effects of intermittent fasting (IF) combined with exercise. The quality of the literature was assessed using the Cochrane tool, followed by a random‐effects statistical analysis of each intervention. Eventually, a NMA was conducted to compare the effectiveness of each intervention on weight loss, thereby determining their combined effectiveness on reducing weight.A total of nine trials, comparing 12 interventions involving 570 participants, were included. All interventions significantly reduced body weight (BW) and fat mass (FM) compared to the control (CON) group. In terms of BW reduction, the alternate‐day fasting + moderate‐intensity continuous training (ADF + MICT) intervention had the highest surface under the cumulative ranking curve average (SUCRA) score 88.1(MD: −4.44,95% CI −5.95, −2.92). Furthermore, for improving FM, the ADF + MICT intervention also had the highest SUCRA score 92.7(MD: −3.65,95% CI −5.05, −2.25), making it the optimal intervention for improving FM.The NMA results indicate that all interventions are effective in reducing weight. Among them, ADF + MICT is the most effective strategy for reducing BW, and it is also the best approach for improving FM. [ABSTRACT FROM AUTHOR]

Summary: Semaglutide is found to be efficient for weight loss in patients with overweight or obesity with diabetes mellitus (DM). With a wide range of adverse events reported, the efficacy and safety of once‐weekly subcutaneous semaglutide in individuals without DM, with overweight or obesity, is unclear. We conducted a comprehensive meta‐analysis of randomized studies on once‐weekly semaglutide in this patient population. We identified nine studies with 11,641 patients in the semaglutide group and 10,479 in the placebo group. We observed that semaglutide resulted in significant benefits, including change in body weight (%): mean difference (MD) of −11.49% (p < 0.0001), change in absolute body weight: MD of −11.74 kg (p < 0.0001), and change in waist circumference: MD of −9.06 cm (p < 0.0001). Gastrointestinal side effects are predominant including nausea: odds ratio (OR) of 4.06 (p < 0.0001), vomiting: OR of 4.43 (p < 0.0001), diarrhea: OR of 2.10 (p < 0.0001), constipation: OR of 2.43 (p < 0.0001), gallbladder disorders: OR of 1.26 (p = 0.010), and cholelithiasis: OR of 2.06 (p = 0.04). Serious adverse events were not statistically significant: OR of 1.06 (p = 0.82). However, the percentage of participants discontinuing due to adverse events and gastrointestinal side effects was statistically significant: ORs of 2.22 (p < 0.0001) and 3.77 (p < 0.0001), respectively. This study shows that in patients with overweight or obesity without DM, once‐weekly subcutaneous semaglutide can significantly decrease body weight without risk of serious adverse events when compared with a placebo. However, gastrointestinal side effects are predominant with semaglutide, which can result in medication discontinuation. [ABSTRACT FROM AUTHOR]

Summary: Obesity is a major health burden worldwide. Although bariatric surgery (BS) is recognized as an effective strategy for weight loss and comorbidities improvement, its impact on muscle strength and quality is still unclear. We aimed to examine postoperative changes in muscle strength and quality and their relationship with body mass index (BMI) changes among adults undergoing BS. To this end, we systematically searched the WoS, PubMed, EBSCO, and Scopus databases. The meta‐analyses, which included 24 articles (666 participants), showed that BS reduces absolute lower‐limb isometric strength (ES = −0.599; 95% CI = ‐0.972, −0.226; p = 0.002). Subjects who experienced a more significant reduction in BMI after BS also suffered a higher loss of absolute muscle strength. Similarly, absolute handgrip strength showed a significant decrease (ES = −0.376; 95% CI = −0.630, −0.121; p = 0.004). We found insufficient studies investigating medium‐ and long‐term changes in muscle strength and/or quality after BS. This study provides moderate‐quality evidence that BS‐induced weight loss can reduce the strength of appendicular muscles in the short term, which should be addressed in management these subjects. More high‐quality studies are needed to evaluate the impact of BS on muscle strength and the different domains of muscle quality in the medium and long term (registered on PROSPERO CRD42022332581). [ABSTRACT FROM AUTHOR]

Summary: People with spinal cord injury (SCI) are at greater risk of developing obesity and related co‐morbidities than those without SCI. The objectives of this systematic review were to examine the effectiveness of weight management interventions for people with SCI and to synthesize the experiences of people involved with SCI weight management (e.g., SCI healthcare professionals and caregivers). Five databases were searched (up to July 31, 2023) and 5,491 potentially eligible articles were identified. Following screening, 22 articles were included, comprising 562 adults. There was considerable heterogeneity in study design and weight loss interventions included behavioral nutritional and exercise education sessions, recalling food diaries, exercise interventions, and pharmaceuticals. The mean percentage change of the pooled body mass data equated to −4.0 ± 2.3%, with a range from −0.5 to −7.6%. In addition, 38% of the individuals with SCI who completed a weight loss intervention (N = 262) had a ≥5% reduction in body weight. Collectively, although on average the included interventions led to moderate weight loss, the finding that just over a third of individuals achieved clinically meaningful 5% weight loss suggests that available interventions for this population may need to be improved. [ABSTRACT FROM AUTHOR]

Summary: Adherence is key for achieving the optimal benefits from a weight loss intervention. Despite the number of studies on factors that promote adherence, their findings suggest inconsistent and fragmented evidence. The aim of this study was to review the existing factors of adherence to weight loss interventions and to find factors that facilitate the design of effective intervention programs. Six databases were searched for this umbrella review; after the screening process, 21 studies were included. A total of 47 factors were identified in six groups as relevant for adherence: (i) sociodemographic (n = 7), (ii) physical activity (n = 2), (iii) dietary (n = 8), (iv) behavioral (n = 4), (v) pharmacological (n = 3), and (vi) multi‐intervention (n = 23). In addition, a map of adherence factors was created. The main findings are that with respect to demographic factors, the development of personalized intervention strategies based on the characteristics of specific populations is encouraged. Moreover, self‐monitoring has been shown to be effective in behavioral, dietary, and multi‐interventions, while technology has shown potential in dietary, behavioral, and multi‐interventions. In addition, multi‐interventions are adherence‐promoting strategies, although more evidence is required on adherence to pharmacological interventions. Overall, the factor map can be controlled and modified by researchers and practitioners to improve adherence to weight loss interventions. [ABSTRACT FROM AUTHOR]

Summary: Obesity is a grave concern within the United States, resulting in lost productivity, increased medical costs, and comorbidities with lifelong repercussions. The laparoscopic sleeve gastrectomy is a treatment option for obesity. The following meta‐analysis sought to combine adolescent and adult literature to determine the overall effect of the sleeve gastrectomy on weight loss, to evaluate the effect of age at the time of surgery on weight loss, and to describe and explore variation in weight loss by sample characteristics. Overall weight loss was assessed at proximal and distal points, a dichotomous moderator variable analysis was conducted with subjects ≤21 years of age and >21 years of age, and a meta‐regression assessing % male, % female, and baseline BMI was conducted to assess moderator variables. The laparoscopic sleeve gastrectomy was effective at facilitating weight loss with effect sizes varying from 0.916 to2.816. Age, biological sex, and baseline BMI were not found to have an impact on weight loss. The clinical consequences of prolonged obesity are evident and earlier intervention may be justified to counter the long‐term effects caused by obesity related comorbidities. Standardized reporting of comorbidities and the effect of bariatric surgery on comorbid conditions is essential to allow further analysis. [ABSTRACT FROM AUTHOR]

Summary This study aimed to evaluate the efficacy and safety of duodenal–jejunal bypass liner (DJBL) for obesity and type 2 diabetes mellitus. A comprehensive search of electronic databases was conducted up to September 15, 2022. Thirty studies involving 1751 patients were included. At 12 months post‐implantation, the reduction in body mass index (BMI) was 4.8 kg/m2 (95% CI 4.1, 5.5), with an excess weight loss of 41.3% (95% CI 33.4%,49.2%) and a total weight loss of 13.1% (95% CI 10.1%, 16.0%). Significant decrease was observed in HbA1c and fasting glucose, with a standardized mean difference of − 0.72 (95% CI − 0.95, − 0.48) and − 0.62 (95% CI − 0.82, − 0.42), respectively. However, these improvements in weight loss and glycemic control were only partially sustained after explantation. In situ, DJBL significantly improves blood pressure and lipid levels. The pooled early removal rate was 19%, and the incidence of severe adverse events was 17%, including device migration (6%), gastrointestinal hemorrhage (4%), device obstruction (4%), and hepatic abscess (2%). DJBL offers significant improvement in weight loss and glycemic control, as well as cardiovascular parameters while in situ. Further studies are warranted to better understand the long‐term efficacy and safety of DJBL. The benefits of DJBL need to be carefully weighed against the risks in clinical decision‐making. [ABSTRACT FROM AUTHOR]

Summary Introduction Methods Results Conclusion Weight regain and insufficient weight loss are major challenges after metabolic bariatric surgery (MBS), affecting patients' comorbidities and quality of life. The current systematic review and meta‐analysis aim to assess the efficacy and safety of GLP‐1 receptor agonists (GLP‐1 RA) in patients with weight regain or insufficient weight loss after MBS.A systematic search was conducted across PubMed, Embase, Scopus, and Web of Science databases to find the relevant studies.A total of 19 articles were included. The highest doses of liraglutide and semaglutide were 3 mg per day and 1 mg once weekly, respectively, in the included studies. The mean differences in weight and body mass index after treatment were −7.02 kg or 3.07 kg/m2, −8.65 or −5.22 kg/m2, and −6.99 kg or −3.09 kg/m2 for treatment durations of ≤ 6 months, 6–12 months, and >12 months with liraglutide, respectively. Additionally, weekly semaglutide showed significantly greater weight loss compared to daily liraglutide, with a mean difference of 4.15 kg. Common complications included nausea (19.1%), constipation (8.6%), abdominal pain (3.7%), and vomiting (2.4%).Using GLP‐1 RA is a safe and effective treatment for weight regain and insufficient weight loss after MBS. [ABSTRACT FROM AUTHOR]

Summary: A systematic review and meta‐analysis was conducted to evaluate the relative effectiveness of different dietary macronutrient patterns on changes in resting energy expenditure (REE) in relation to weight loss, categorized as minimal (<5%) and moderate to high (>5%). Changes in REE were assessed using a DerSimonian and Laird random‐effects meta‐analysis. A diet lower in carbohydrates (CHO) or higher in fat and protein was associated with smaller reductions in REE, with these trends being more pronounced among participants who experienced moderate to high weight loss. Adjusted meta‐regression analysis indicated that, within the participants who experienced moderate to high weight loss, each 1% increase in CHO intake was associated with a reduction of 2.30 kcal/day in REE (95% CI: −4.11 to −0.47, p = 0.013). In contrast, a 1% increase in protein and fat intake was correlated with an increase in REE by 3.00 (95% confidence interval [CI] [1.02, 5.07], p = 0.003) and 0.5 (95% CI [−2.43, 3.41], p = 0.740) kcal/day, respectively. No significant associations were found among participants who experienced minimal weight loss. These findings indicate that, under a caloric deficit, the impact of dietary macronutrient composition on REE may vary depending on the degree of weight loss and individual metabolic responses. [ABSTRACT FROM AUTHOR]

Summary: Obesity has emerged as a prevalent global health concern, with its detrimental effects on the reproductive system and sexual function garnering increasing attention. Both men and women affected by obesity face a heightened risk of fertility challenges and sexual dysfunction. Although fertility and sexual function are distinct topics, they are intricately linked and mutually influential in both medical and societal contexts. Bariatric surgery (BS) has generated promising results in alleviating sexual dysfunction and enhancing fertility, results which are often gender specific. In men, improvements in sexual function can often be attributed to weight loss and subsequent optimizations in sex hormone levels. However, improving female sexual function may be related to a range of factors beyond weight loss. Bariatric procedures have shown limited benefits for male fertility; in fact, in some situations it can even be detrimental, leading to a decrease in sperm count and quality. Conversely, BS may positively impact female fertility, improving pregnancy and neonatal outcomes. Nevertheless, it is essential to consider the potential risks related to the adverse effects of malnutrition and rapid weight loss following BS, making it advisable to wait for 12–18 months before attempting pregnancy. [ABSTRACT FROM AUTHOR]

Summary Childhood obesity represents a significant public health concern, imposing a substantial burden on the healthcare system. Furthermore, weight‐loss programs often exhibit reduced effectiveness in adults who have a history of childhood obesity. Therefore, early intervention against childhood obesity is imperative. Presently, the primary method for diagnosing childhood obesity relies on body mass index (BMI), yet this approach has inherent limitations. Leptin, a satiety hormone produced by adipocytes, holds promise as a superior tool for predicting both childhood and subsequent adulthood obesity. In this review, we elucidate the tools employed for assessing obesity in children, delve into the biological functions of leptin, and examine the factors governing its expression. Additionally, we discuss maternal and infantile leptin levels as predictors of childhood obesity. By exploring the relationship between leptin levels and weight loss, we present leptin as a potential indicator of the effectiveness of obesity interventions. [ABSTRACT FROM AUTHOR]

This document contains summaries of several articles related to obesity research. The first article discusses the effects of bisphenols on liver metabolism and toxicity. The second article explores the impact of high-intensity interval training on cardiac function in obese rats. The third article investigates the role of immune cell recruitment in protecting mice from metabolic dysfunction caused by a high-fat diet. The fourth article examines the susceptibility to obesity in female mice lacking a specific liver receptor. The final article proposes a combination therapy approach using a non-coding RNA inhibitor and a GLP-1 RA to enhance the effectiveness of obesity treatment. [Extracted from the article]

This document is a compilation of research articles that explore various aspects of obesity in Brazil. The articles cover topics such as weight bias internalization, hospitalizations for obesity, anti-fat attitudes among medical students, the impact of the COVID-19 pandemic on severe obesity in children, and the portrayal of obesity in news images. Other topics include the misuse of anti-obesity medications, the relationship between obesity and chronic pain, and the effects of different interventions on metabolic parameters and body weight. These articles provide valuable insights into the multifaceted nature of obesity and its impact on individuals and society in Brazil. [Extracted from the article]

Summary: This review synthesized the evidence from randomized controlled trials comparing the effect of meal replacements (MRs) as part of a weight loss intervention with conventional food‐based weight loss diets on cardiometabolic risk in individuals with pre‐diabetes and features of metabolic syndrome. MEDLINE, EMBASE, and Cochrane Library were searched through January 16, 2024. Data were pooled using the generic inverse variance method and expressed as mean difference [95% confidence intervals]. The overall certainty of the evidence was assessed using GRADE. Ten trials (n = 1254) met the eligibility criteria. MRs led to greater reductions in body weight (−1.38 kg [−1.81, −0.95]), body mass index (BMI, −0.56 kg/m2 [−0.78, −0.34]), waist circumference (−1.17 cm [−1.93, −0.41]), HbA1c (−0.11% [−0.22, 0.00]), LDL‐c (−0.18 mmol/L [−0.28, −0.08]), non‐HDL‐c (−0.17 mmol/L [−0.33, −0.01]), and systolic blood pressure (−2.22 mmHg [−4.20, −0.23]). The overall certainty of the evidence was low to moderate owing to imprecision and/or inconsistency. The available evidence suggests that incorporating MRs into a weight loss intervention leads to small important reductions in body weight, BMI, LDL‐c, non‐HDL‐c, and systolic blood pressure, and trivial reductions in waist circumference and HbA1c, beyond that seen with conventional food‐based weight loss diets. [ABSTRACT FROM AUTHOR]

Summary: ChatGPT/GPT‐4 is a conversational large language model (LLM) based on artificial intelligence (AI). The potential application of LLM as a virtual assistant for bariatric healthcare professionals in education and practice may be promising if relevant and valid issues are actively examined and addressed. In general medical terms, it is possible that AI models like ChatGPT/GPT‐4 will be deeply integrated into medical scenarios, improving medical efficiency and quality, and allowing doctors more time to communicate with patients and implement personalized health management. Chatbots based on AI have great potential in bariatric healthcare and may play an important role in predicting and intervening in weight loss and obesity‐related complications. However, given its potential limitations, we should carefully consider the medical, legal, ethical, data security, privacy, and liability issues arising from medical errors caused by ChatGPT/GPT‐4. This concern also extends to ChatGPT/GPT ‐4's ability to justify wrong decisions, and there is an urgent need for appropriate guidelines and regulations to ensure the safe and responsible use of ChatGPT/GPT‐4. [ABSTRACT FROM AUTHOR]

Summary: Elevated body mass index (BMI) is linked to increased pancreatic cancer (PC) risk. Cancer‐associated weight loss can occur years before the malignancy is diagnosed. This might have led to underestimation of the BMI‐PC association. However, it is unknown if and to what extent this issue has been considered in previous epidemiological studies. We searched two databases through February 19, 2024 for systematic reviews, meta‐analyses, and pooled analyses examining the BMI‐PC association. We extracted information on study design with a special focus on the article's examination of prediagnostic weight loss as a potential source of bias, as well as how included cohort studies addressed this concern. Thirteen review articles, meta‐analyses, and pooled analyses were identified. Only five (four pooled analyses, one systematic review) considered prediagnostic weight loss in their analyses. Twenty‐four of 32 identified cohort studies reported having excluded initial years of follow‐up. However, only 13 studies reported results after such exclusions, and effect estimates generally increased with longer periods of exclusion. We conclude that the association of overweight and obesity with PC risk is likely larger than suggested by published epidemiological evidence. Future studies should pay careful attention to avoid or minimize potential bias resulting from prediagnostic weight loss. [ABSTRACT FROM AUTHOR]

Summary: The optimal treatment and organization of care for people with obesity is one of the greatest challenges facing today's health services. While surgery and pharmacotherapy offer effective treatment options for some people with obesity, behavioral interventions are important to support long‐term behavioral change. However, little is known about the most effective components of behavioral interventions, and this is especially the case for people with complex or severe obesity (i.e. body mass index [BMI] > 35 kg/m2). Accordingly, the current rapid review aimed to identify which behavior change techniques (BCTs) are effective for weight loss in adults with (severe) obesity. A secondary aim was to review the effects of BCTs on dietary behaviors and physical activity, and psychological outcomes, recognizing that behavioral interventions commonly target these. A search of Scopus, Ovid Medline, and Web of Science resulted in 1227 results, with 22 reviews eligible for inclusion. The most commonly reported BCTs were self‐monitoring and goal setting, but these had variable effects on weight in adults with obesity. Combining these BCTs with other self‐regulatory techniques led to increased weight loss. Further, for adults with severe obesity, so‐called 'nudge' techniques and self‐regulatory techniques were associated with greater weight loss. Three reviews also found that while self‐monitoring increased physical activity, behavioral commitments increased changes to dietary behaviors. BCTs were not associated with psychological well‐being. The review confirms that behavioral interventions have an impact in weight management, including for individuals with more complex or severe obesity, but highlights the need for further investigation of their use within clinical settings. [ABSTRACT FROM AUTHOR]

Summary: Type 2 diabetes mellitus (T2DM) is a highly prevalent metabolic disease, causing a heavy burden on healthcare systems worldwide, with related complications and anti‐diabetes drug prescriptions. Recently, it was demonstrated that T2DM can be put into remission via significant weight loss using low‐carbohydrate diets (LCDs) and very low‐energy diets (VLEDs) in individuals with overweight and obesity. Clinical trials demonstrated remission rates of 25–77%, and metabolic improvements such as improved blood lipid profile and blood pressure were observed. In contrast, clinical trials showed that remission rate declines with time, concurrent with weight gain, or diminished weight loss. This review aims to discuss existing literature regarding underlying determinants of long‐term remission of T2DM including metabolic adaptations to weight loss (e.g., role of gastrointestinal hormones), type of dietary intervention (i.e., LCDs or VLEDs), maintaining beta (β)‐cell function, early glycemic control, and psychosocial factors. This narrative review is significant because determining the factors that are associated with challenges in maintaining long‐term remission may help in designing sustainable interventions for type 2 diabetes remission. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Multiple factors are related to lower weight loss after bariatric surgery. This review and meta‐analysis evaluates the influence of several mental and behavioral factors on weight loss. Method: Six electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non‐moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow‐up moments were analyzed separately. Results: In total, 75 articles were included in the review; 12 meta‐analyses were conducted. Higher postoperative compliance to follow‐up was associated with 6.86%–13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24‐ and 36‐month follow‐up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms. Conclusion: Despite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric‐metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss. [ABSTRACT FROM AUTHOR]

Summary: Aim: The aim of this study is to examine which interventions lead to clinically significant weight loss among people with physical disabilities. Methods: We systematically searched three electronic databases (PubMed, Scopus, and CENTRAL) including studies until May 2022 to find randomized controlled trials on behavioral interventions and weight‐related outcomes in people with physical disabilities. Pharmacological or surgical interventions were excluded. Study quality was evaluated using the Cochrane Risk of Bias Tool. Interventions were grouped as dietary, physical activity, education/coaching, or multi‐component. Mean weight changes, standard deviations, confidence intervals, and effect sizes were extracted or calculated for assessment of the intervention effect. Results: Sixty studies involving 6,511 participants were included in the qualitative synthesis. Most studies (n = 32) included multi‐component interventions, incorporating dietary and physical activity components. Limited evidence suggests that extensive dietary interventions or long‐term multi‐component interventions might lead to a clinically relevant weight reduction of at least 5% for older individuals (age > 50) with mild‐to‐moderate mobility impairments. Discussion: Due to the high heterogeneity of studies and low study quality, it can be assumed that the range of applicability of the findings is questionable. Further research should examine younger age groups (i.e., children, adolescents, and adults under 40 years) and compare different settings such as schools, clinics, nursing homes, and assisted living facilities. [ABSTRACT FROM AUTHOR]

Summary: Potent incretin‐based therapy shows promise for the treatment of obesity along with reduced incidence of cardiovascular events in patients with preexisting cardiovascular disease and obesity. This study assessed the efficacy and safety of the incretin‐based obesity treatments, once‐weekly subcutaneous semaglutide 2.4 mg and tirzepatide 10 or 15 mg, in people with obesity without diabetes. Of the 744 records identified, seven randomized controlled trials (n = 5140) were included. Five studies (n = 3288) investigated semaglutide and two studies (n = 1852) investigated tirzepatide. The treatment effect, shown as placebo‐subtracted difference, on body weight was −15.0% (95% CI, −17.8 to −12.2) with −12.9% (95% CI, −14.7 to −11.1) for semaglutide and −19.2% (95% CI, −22.2 to −16.2) for tirzepatide. The treatment effect on waist circumference was −11.4 cm (95% CI, −13.7 to −9.2) with −9.7 cm (95% CI, −10.8 to −8.5) for semaglutide and −14.6 cm (95% CI, −15.8 to −13.4) for tirzepatide. The adverse events related to semaglutide and tirzepatide were primarily of mild‐to‐moderate severity and mostly gastrointestinal, which was more frequent during the dose‐titration period and leveled off during the treatment period. This emphasizes that once‐weekly subcutaneous semaglutide 2.4 mg and tirzepatide 10 or 15 mg induce large reductions in body weight and waist circumference and are generally well‐tolerated. [ABSTRACT FROM AUTHOR]

Summary: Background and Objective: Almond consumption has an inverse relationship with obesity and factors related to metabolic syndrome. However, the results of available clinical trials are inconsistent. Therefore, we analyzed the results of 37 randomized controlled trials (RCTs) and evaluated the association of almond consumption with subjective appetite scores and body compositions. Methods: Net changes in bodyweight, body mass index (BMI), waist circumference (WC), fat mass (FM), body fat percent, fat‐free mass (FFM), waist‐to‐hip ratio (WHR), visceral adipose tissue (VAT), and subjective appetite scores were used to calculate the effect size, which was reported as a weighted mean differences (WMD) and 95% confidence interval (CI). Results: This meta‐analysis was performed on 37 RCTs with 43 treatment arms. The certainty in the evidence was very low for appetite indices, body fat percent, FFM, VAT, and WHR, and moderate for other parameters as assessed by the GRADE evidence profiles. Pooled effect sizes indicated a significant reducing effect of almond consumption on body weight (WMD: −0.45 kg, 95% CI: −0.85, −0.05, p = 0.026), WC (WMD: −0.66 cm, 95% CI: −1.27, −0.04, p = 0.037), FM (WMD: −0.66 kg, 95% CI: −1.16, −0.17, p = 0.009), and hunger score (WMD: −1.15 mm, 95% CI: −1.98, −0.32, p = 0.006) compared with the control group. However, almond did not have a significant effect on BMI (WMD: −0.20 kg m−2, 95% CI: −0.46, 0.05, p = 0.122), body fat percent (WMD: −0.39%, 95% CI: −0.93, 0.14, p = 0.154), FFM (WMD: −0.06, 95% CI: −0.47, 0.34, p = 0.748), WHR (WMD: −0.04, 95% CI: −0.12, 0.02, p = 0.203), VAT (WMD: −0.33 cm, 95% CI: −0.99, 0.32), fullness (WMD: 0.46 mm, 95% CI: −0.95, 1.88), desire to eat (WMD: 0.98 mm, 95% CI: −4.13, 2.23), and prospective food consumption (WMD: 1.08 mm, 95% CI: −2.11, 4.28). Subgroup analyses indicated that consumption of ≥50 g almonds per day resulted in a significant and more favorable improvement in bodyweight, WC, FM, and hunger score. Body weight, WC, FM, body fat percent, and hunger scores were decreased significantly in the trials that lasted for ≥12 weeks and in the subjects with a BMI < 30 kg/m2. Furthermore, a significant reduction in body weight and WC was observed in those trials that used a nut‐free diet as a control group, but not in those using snacks and other nuts. The results of our analysis suggest that almond consumption may significantly improve body composition indices and hunger scores when consumed at a dose of ≥50 g/day for ≥12 weeks by individuals with a BMI < 30 kg/m2. Conclusion: However, further well‐constructed randomized clinical trials are needed in order ascertain the outcome of our analysis. [ABSTRACT FROM AUTHOR]

Summary: Glucagon‐like peptide 1 (GLP‐1) receptor agonists are revolutionizing obesity and type 2 diabetes treatment, delivering remarkable weight loss outcomes. These medications, leveraging the effects of the insulin‐regulating hormone GLP‐1 via actions on peripheral and central nervous system targets, have raised hopes with their bariatric surgery‐rivaling results. However, questions remain about their long‐term safety and efficacy. Drawing from our expertise in obesity medicine and psychiatry, we reflect upon our experiences with the clinical use of these medications and delve into the nuanced challenges and risks they pose, particularly for those prone to disordered eating or those diagnosed with rare genetic diseases of obesity. We contend that effectively managing weight loss within this "danger zone" necessitates (1) proactive screening and continuous monitoring for disordered eating, (2) vigilant monitoring for appetite‐related maladaptive responses, including food aversion and dehydration, and (3) ongoing assessment for broader health impacts. A multifaceted, interdisciplinary approach that melds medical, psychological, dietary, and behavioral strategies is crucial to delivering tailored and thorough care to each patient. [ABSTRACT FROM AUTHOR]

Summary: While the "precision nutrition" movement is at an early stage of development, several investigations have compared low‐fat versus carbohydrate (CHO)‐modified diets (i.e., low‐or‐reduced‐CHO, low glycemic index/load diets, and high‐fiber) in people with normal versus impaired glucose metabolism. The purpose of this scoping review was to summarize evidence in support of the hypothesis that CHO‐modified diets are more effective for weight loss among people with impaired glucose metabolism. Fifteen articles were included in this review: seven retrospective analyses of randomized clinical trials and eight prospective randomized clinical trials with prespecified hypotheses related to a diet (low‐fat vs. CHO‐modified) × phenotype (normal vs. impaired) interaction. Evidence in support of the hypothesis was identified in six of seven retrospective and three of eight prospective studies, which led to a recommendation of CHO‐modified diets as a first‐line option for people with impaired glucose metabolism. However, the evidence in support of this recommendation is relatively weak, and dietary prescriptions should consider additional contextual information that may influence overall dietary adherence. Additional and rigorous research using innovative randomized experimental approaches is needed for stronger dietary weight loss recommendations based on pretreatment glycemic status. [ABSTRACT FROM AUTHOR]

Summary: Melatonin appears to be a promising supplement for obesity treatment. The antiobesity effects of melatonin on obese rodents are influenced by various factors, including the species, sex, the dosage of melatonin, treatment duration, administration via, daily treatment time, and initial body weight (IBW). Therefore, we conducted a meta‐analysis and machine learning study to evaluate the antiobesity effect of melatonin on obese mice or rats from 31 publications. The results showed that melatonin significantly reduced body weight, serum glucose (GLU), triglycerides (TGs), low‐density lipoprotein (LDL), and cholesterol (TC) levels in obese mice or rats but increased high‐density lipoprotein (HDL) levels. Melatonin showed a slight positive effect on clock‐related genes, although the number of studies was limited. Meta‐regression analysis and machine learning indicated that the dosage of melatonin was the primary factor influencing body weight, with higher melatonin dosages leading to a stronger weight reduction effect. Together, male obese C57BL/6 mice and Sprague–Dawley rats with an IBW of 100–200 g showed better body weight reduction when supplemented with a dose of 10–30 mg/kg melatonin administered at night via injection for 5–8 weeks. [ABSTRACT FROM AUTHOR]

Summary: Introduction: Weight loss is recommended for individuals with obstructive sleep apnea (OSA) and overweight or obesity, but there is limited evidence to guide the selection of weight management strategies for patients who do not lose sufficient weight with diet and lifestyle changes. We evaluated the relationship between weight loss caused by pharmacologic or surgical interventions and subsequent improvement in OSA by the apnea‐hypopnea index (AHI). Methods: PubMed, Cochrane CENTRAL, and EMBASE were searched for randomized trials comparing pharmacologic or surgical obesity interventions to usual care, placebo, or no treatment in adults with OSA. The association between percentage weight loss and AHI change between randomization and last follow‐up was evaluated using meta‐regression. PROSPERO: CRD42022378853. Results: Ten eligible trials (n = 854 patients) were included. Four (n = 211) assessed bariatric surgery, and 6 (n = 643) assessed pharmacologic interventions over a median follow‐up of 13 months (interquartile range 6–26 months). The linear best estimate of the change in AHI is 0.45 events per hour (95% Confidence Interval 0.18 to 0.73 events per hour) for every 1% body weight lost. Conclusions: Weight loss caused by medication or surgery caused a proportionate improvement of the AHI. Providers could consider extrapolating from this relationship when advising patients of the expected effects of other pharmacologic or surgical interventions without direct evidence in OSA. [ABSTRACT FROM AUTHOR]

Summary: Postpartum weight retention (PPWR) increases the risk of long‐term obesity and metabolic disease in women with recent gestational diabetes mellitus (GDM). This systematic review aimed to assess the effectiveness of dietary and physical activity behavior interventions in reducing PPWR. We systematically searched 13 electronic databases to retrieve articles published in English or Chinese before October 22, 2022. Randomized controlled trials (RCTs) that assessed dietary and/or physical activity behaviors interventions on the outcomes of PPWR among women with recent GDM were included. Twelve studies researched a total of 5672 participants. The meta‐analysis indicated that dietary and physical activity behaviors interventions showed significant effects on the pooled effect size of body weight changes (WMD = −2.19, 95% CIs: −3.39, −0.98 kg), body mass index (WMD = −0.98, 95% CIs: −1.56, −0.39 kg/m2), and waist circumference (WMD = −1.20, 95% CIs: −2.49, 0.08 cm). Furthermore, the intervention group was more likely to achieve weight reduction (OR = 0.76, 95% CIs: 0.67, 0.87) than the control group. Postpartum dietary and physical activity behavior interventions for women with a recent GDM can reduce PPWR, and 1 year postpartum may be a window of opportunity. [ABSTRACT FROM AUTHOR]

Summary: Background: Growing evidence indicates that incretin‐based therapies (IBTs), glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs), and dipeptidyl peptidase‐4 inhibitors (DPP4is) are effective and safe for treating pediatric obesity patients with or without type 2 diabetes. Therefore, we aimed to perform a systematic review and meta‐analysis for updating current evidence. Methods: We searched the PubMed, the Cochrane Library, and the EMBASE database for articles published until September 15, 2023, and limited to randomized control trials. The primary outcomes were changed from baseline in weight metrics and the cardiometabolic profile. A random effects model will be used, as high heterogeneity is expected. All analyses were performed using STATA 17.0. Results: Fifteen trials with a total number of 1286 participants were included in our meta‐analysis. Overall, the mean difference in weight change between the IBTs group and the control group was −2.89 kg (95% confidence interval, −5.12 to −0.65, p = 0.011). Additionally, IBTs significantly reduced the HbA1c level and fasting plasma glucose by 0.37% and 6.99 mg/dl, compared with control groups. IBTs showed a little increased risk of GI side effects and hypoglycemia events, but none of the severe hypoglycemia events were occurred in IBTs group. Conclusions: Our study results have proved that GLP‐1 RAs are safe, acceptable, and effective in weight reduction and sugar control for children with obesity. In addition, DPP‐4is seems to have no effect on glycemic control and weight loss in childhood obesity. Further research is needed to confirm these findings, especially in younger children. [ABSTRACT FROM AUTHOR]

Summary: A panel of 10 experts in obesity from various Latin American countries held a Zoom meeting intending to reach a consensus on the use of anti‐obesity medicines and make updated recommendations suitable for the Latin American population based on the available evidence. A questionnaire with 16 questions was developed using the Patient, Intervention, Comparison, Outcome (Result) methodology, which was iterated according to the modified Delphi methodology, and a consensus was reached with 80% or higher agreement. Failure to reach a consensus led to a second round of analysis with a rephrased question and the same rules for agreement. The recommendations were drafted based on the guidelines of the American College of Cardiology Foundation/American Heart Association Task Force on Practice. This panel of experts recommends drug therapy in patients with a body mass index of ≥30 or ≥27 kg/m2 plus at least one comorbidity, when lifestyle changes are not enough to achieve the weight loss objective; alternatively, lifestyle changes could be maintained while considering individual parameters. Algorithms for the use of long‐term medications are suggested based on drugs that increase or decrease body weight, results, contraindications, and medications that are not recommended. The authors concluded that anti‐obesity treatments should be individualized and multidisciplinary. [ABSTRACT FROM AUTHOR]

Summary: Shift workers have an increased risk of obesity and metabolic conditions. This mixed‐methods systematic literature review on night shift workers aimed to: (1) identify barriers/enablers of weight management; (2) examine effectiveness of weight management interventions; and (3) determine whether interventions addressed enablers/barriers. Six databases were searched, articles screened by title/abstract, followed by full‐text review, and quality assessment. Eligible qualitative studies documented experiences of behaviors related to weight change. Eligible quantitative studies were behavior change interventions with weight/body mass index outcomes. A thematic synthesis was undertaken for qualitative studies using the social‐ecological model (SEM). Interventions were synthesized narratively including: weight/body composition change; components mapped by behavior change taxonomy; and SEM. A synthesis was undertaken to identify if interventions addressed perceived enablers/barriers. Eight qualitative (n = 169 participants) and 12 quantitative studies (n = 1142 participants) were included. Barriers predominated discussions: intrapersonal (time, fatigue, stress); interpersonal (work routines/cultural norms); organizational (fatigue, lack of: routine, healthy food options, breaks/predictable work); community (lack of healthy food options). The primary outcome for interventions was not weight loss and most did not address many identified enablers/barriers. One intervention reported a clinically significant weight loss result. Weight loss interventions that address barriers/enablers at multiple SEM levels are needed. [ABSTRACT FROM AUTHOR]

Depending on the nature of their sports, athletes may be engaged in successive weight loss (WL) and regain, conducing to "weight cycling." The aims of this paper were to systematically (and meta‐analytically when possible) analyze the post‐WL recovery of (i) body weight and (ii) fat mass; fat‐free mass; and performance and metabolic responses in weight cycling athletes (18–55 years old, body mass index < 30 kg.m−2). MEDLINE, Embase, and SPORTDiscus databases were explored. The quality and risk of bias of the 74 included studies were assessed using the quality assessment tool for quantitative studies. Thirty‐two studies were eligible for meta‐analyses. Whatever the type of sports or methods used to lose weight, post‐WL body weight does not seem affected compared with pre‐WL. While similar results are observed for fat‐free mass, strength sports athletes (also having longer WL and regain periods) do not seem to fully recover their initial fat mass (ES: −0.39, 95% CI: [−0.77; −0.00], p = 0.048, I2 = 0.0%). Although the methods used by athletes to achieve WL might prevent them from a potential post‐WL fat overshooting, further studies are needed to better understand WL episodes consequences on athletes' performance as well as short‐ and long‐term physical, metabolic, and mental health. [ABSTRACT FROM AUTHOR]

Summary: In 2007, the Scandinavian Obesity Surgery Registry (SOReg) was started by the profession to monitor the results of bariatric surgery and to provide a high‐quality database for research. In the end of August 2023, SOReg contains 88,379 patients (body mass index [BMI] 41.7 kg/m2, 41.2 years, 77.1% females, gastric bypass 76.8%). In this narrative review, we demonstrate that preoperative weight loss is of value and that the laparoscopic double omega‐loop technique is highly suitable for gastric bypass. Closing the mesenteric openings is, however, important. Swedish bariatric surgery has low mortality, and our results are comparative to those of other countries. Significant long‐term improvements are found in common obesity‐related diseases such as diabetes, hypertension, and sleep apnea. Furthermore, the risk for cardiac failure and major adverse cardiovascular events is significantly reduced. Pregnancy‐related outcomes are also improved. Gastric bypass results in significant improvements in quality of life and seems to be cost saving. We have revealed that low socioeconomic status is associated with reduced chance of undergoing bariatric surgery and inferior outcomes. Of note, we have performed several randomized clinical trials within the registry database. In conclusion, high‐quality national registry databases, such as SOReg, are important for maintaining high‐quality care and present a platform for extensive research. [ABSTRACT FROM AUTHOR]

Summary: Background: Intake of sugar‐sweetened beverages has been associated with weight gain. It is uncertain if replacing an existing use of sugar‐sweetened beverages with non‐caloric beverages results in long‐term reduction in body weight. Objective: The objective of this study is to explore if a long‐term reduction in body weight can be achieved by replacing an existing intake of sugar‐sweetened beverages with non‐caloric beverages. Methods: Systematic review and meta‐analysis of randomized clinical trials in accordance with PRISMA guidelines. PubMed and EMBASE were searched for literature. Studies with a "substitution" design were included, that is, studies where subjects substituted an existing intake of sugar‐sweetened beverages with either artificially sweetened beverages or unsweetened beverages/water. Studies with 6 months or longer follow‐up of weight change were included. Results: Six trials with a total of 1729 participants were included in the meta‐analysis. Replacing an existing intake of sugar‐sweetened beverages with a non‐caloric beverage resulted in a long‐term BMI reduction of 0.31 kg/m2 compared with the sugar‐sweetened beverage‐group (95% CI; 0.17–0.44). One study with 1 year's intervention and 2 years follow‐up showed a regression towards baseline BMI after the intervention had ended. Conclusion: Replacing an existing use of sugar‐sweetened beverages with artificially sweetened beverages or unsweetened beverages resulted in a long‐term 0.31 kg/m2 reduction in BMI equivalent to 0.5–1 kg in children and adults, respectively, as long as the interventions lasted. [ABSTRACT FROM AUTHOR]

Summary: Weight stigma, defined as pervasive misconceptions and stereotypes associated with higher body weight, is both a social determinant of health and a human rights issue. It is imperative to consider how weight stigma may be impeding health promotion efforts on a global scale. The World Obesity Federation (WOF) convened a global working group of practitioners, researchers, policymakers, youth advocates, and individuals with lived experience of obesity to consider the ways that global obesity narratives may contribute to weight stigma. Specifically, the working group focused on how overall obesity narratives, food and physical activity narratives, and scientific and public‐facing language may contribute to weight stigma. The impact of weight stigma across the lifespan was also considered. Taking a global perspective, nine recommendations resulted from this work for global health research and health promotion efforts that can help to reduce harmful obesity narratives, both inside and outside health contexts. [ABSTRACT FROM AUTHOR]

Summary: The extent to which genetic variations contribute to interindividual differences in weight loss and metabolic outcomes after bariatric surgery is unknown. Identifying genetic variants that impact surgery outcomes may contribute to clinical decision making. This review evaluates current evidence addressing the association of genetic variants with weight loss and changes in metabolic parameters after bariatric surgery. A search was conducted using Medline, Embase, Scopus, Web of Science, and Cochrane Library. Fifty‐two eligible studies were identified. Single nucleotide polymorphisms (SNPs) at ADIPOQ (rs226729, rs1501299, rs3774261, and rs17300539) showed a positive association with postoperative change in measures of glucose homeostasis and lipid profiles (n = 4), but not with weight loss after surgery (n = 6). SNPs at FTO (rs11075986, rs16952482, rs8050136, rs9939609, rs9930506, and rs16945088) (n = 10) and MC4R (rs11152213, rs476828, rs2229616, rs9947255, rs17773430, rs5282087, and rs17782313) (n = 9) were inconsistently associated with weight loss and metabolic improvement. Four studies examining the UCP2 SNP rs660339 reported associations with postsurgical weight loss. In summary, there is limited evidence supporting a role for specific genetic variants in surgical outcomes after bariatric surgery. Most studies have adopted a candidate gene approach, limiting the scope for discovery, suggesting that the absence of compelling evidence is not evidence of absence. [ABSTRACT FROM AUTHOR]

Summary: Individuals with obesity can attain significant weight loss in a relatively short timeframe following bariatric surgery; however, new healthy behaviors must be sustained in perpetuity to maintain weight loss. This study investigates patients' views on the facilitators and barriers to long‐term weight loss maintenance following bariatric surgery. Systematic searches of Medline, PsycINFO, and CINAHL databases identified 403 studies with 15 fitting the study inclusion criteria. Included studies were independently appraised using Critical Appraisal Skills Program (CASP). Data extraction and thematic synthesis generated three themes: changing food relationships, navigating inter‐ and intrapersonal influences, and caring health professionals. These appeared across six organizing sub‐themes: building new food relationships, creating healthy habits, relationships with others, internalized stressors, finding and defining success, and ongoing patient education. Patients experienced a variety of barriers and facilitators to weight loss maintenance, with some facilitators diminishing over time. The findings demonstrate the importance of considering patients' perspectives and individual contexts to assist them to negotiate and overcome challenges to long‐term weight loss maintenance post‐bariatric surgery. [ABSTRACT FROM AUTHOR]

Summary: Weight regain or inadequate weight loss following Roux‐en‐Y gastric bypass poses a significant clinical challenge. Our objective was to evaluate various revisional techniques for addressing weight regain and insufficient weight loss after Roux‐en‐Y gastric bypass through a systematic review and meta‐analysis. We performed a literature search (in PubMed and Embase) on revisional interventions in collaboration with a medical information specialist. Measured outcomes included body mass index at intervention, total weight loss during follow‐up, and complications. Random effects models were used to determine pooled effect size and corresponding 95% confidence intervals. Thirty‐nine studies were included: four studies reported on argon plasma coagulation, four studies on transoral outlet reduction, nine studies on transoral outlet reduction + argon plasma coagulation, four studies on pouch/gastrojejunal anastomosis revision, five on laparoscopic gastric banding, two studies on laparoscopic gastric banding + pouch resizing, 10 on distalization‐RYGB, and one on duodenal switch. All techniques resulted in short‐term clinically relevant weight loss. Endoscopic procedures had a short follow‐up and resulted in modest and temporary weight loss. Surgical revision techniques were successful for weight loss in longer term follow‐up, at the expense of high complication rates. [ABSTRACT FROM AUTHOR]

Summary: Dietary temptations and lapses challenge control over eating and act as barriers toward successful weight loss. These are difficult to assess in laboratory settings or with retrospective measures as they occur momentarily and driven by the current environment. A better understanding of how these experiences unfold within real‐world dieting attempts could help inform strategies to increase the capacity to cope with the changes in appetitive and affective factors that surround these experiences. We performed a narrative synthesis on the empirical evidence of appetitive and affective outcomes measured using ecological momentary assessment (EMA) during dieting in individuals with obesity and their association with dietary temptations and lapses. A search of three databases (Scopus, Medline, and PsycInfo) identified 10 studies. Within‐person changes in appetite and affect accompany temptations and lapses and are observable in the moments precipitating a lapse. Lapsing in response to these may be mediated through the strength of a temptation. Negative abstinence‐violation effects occur following a lapse, which negatively impact self‐attitudes. Engagement in coping strategies during temptations is effective for preventing lapses. These findings indicate that monitoring changes in sensations during dieting could help identify the crucial moments when coping strategies are most effective for aiding with dietary adherence. [ABSTRACT FROM AUTHOR]

Summary: This systematic review and meta‐analysis evaluates metabolic and anthropometric outcomes of duodenal–jejunal bypass liners (DJBLs) compared to optimal medical management for the treatment of obesity and its associated metabolic complications. A systematic search of MEDLINE, Embase, Scopus, and Web of Science databases was conducted. Studies were reviewed and data were extracted following the PRISMA guidelines. The primary outcome was glycated hemoglobin (HbA1c) change at device explant with secondary outcomes including body mass index (BMI), weight, fasting plasma glucose (FPG), and adverse events. Twenty‐eight studies met inclusion criteria evaluating a total of 1229 patients undergoing DJBL treatment. When compared to medical management, DJBLs provided superior reductions in HbA1c (mean difference, MD −0.96%; 95% CI −1.43, −0.49; p < 0.0001), FPG (MD −1.76 mmol/L; 95% CI −2.80, −0.72; p = 0.0009), BMI (MD −2.80 kg/m2; 95% CI −4.18, −1.41; p < 0.0001), and weight (MD −5.45 kg; 95% CI −9.80, −1.09, p = 0.01). Post‐explant data reveals a gradual return to baseline status. Incidence of early device explant was 20.2%. Complications were resolved conservatively or with device explant without long‐term morbidity or mortality. We conclude that DJBLs provide significant metabolic and anthropometric improvements for patients with obesity. Uncertainty about the extent to which improvements are maintained after device removal may limit the use of DJBLs as a standalone treatment for obesity and associated metabolic complications. [ABSTRACT FROM AUTHOR]

Summary: Numerous barriers are experienced by people with overweight and obesity that play a role in the implementation of lifestyle interventions. This systematic review aims to investigate the barriers and facilitators for children and adults with overweight or obesity when implementing lifestyle interventions targeting weight loss in primary care. A systematic review was conducted by searching four databases to identify eligible studies (1969–2022). The Critical Appraisal Skills Program was used to assess the study quality. A total of 28 studies were included, of which 21 focused on adults and seven on children and their parents. Thematic synthesis of the 28 studies included identified nine key themes, of which support, role of the general practitioner, structure of the lifestyle intervention program, logistics, and psychological factors were the most common. This review shows that a strong support system and a personalized lifestyle intervention are essential components for successful implementation. Additional research is needed to identify whether future lifestyle interventions can take these barriers and facilitators into account and still be feasible for losing weight. [ABSTRACT FROM AUTHOR]

Summary: Obesity treatment requires a chronic state of negative energy balance. Obesity medications can help with this, increasing long‐term dietary compliance by promoting satiety or reducing hunger. However, efficacy and safety of obesity medications vary for individuals. Early identification of non‐responders to obesity medications may limit drug exposure while optimizing benefits for responders. This review summarizes factors that impact weight‐loss response to liraglutide. Factors linked to greater weight loss on liraglutide include being female, not having diabetes, having relatively high baseline weight, and losing at least 4% of initial weight after 16 weeks of treatment. Other covariates that may predict treatment response but require further confirmation include central effects, nausea, gastric emptying of solids, and genotype. Baseline body mass index, race, and age seem less relevant for predicting weight‐loss response to liraglutide. Lesser known and harder‐to‐measure factors such as cerebral blood flow, food cue reactivity, gut hormone levels, and dietary adherence possibly impact variability of response to liraglutide. This information should assist healthcare providers with establishing realistic weight‐loss probability for individual patients. Future research should improve the ability to identify responders to liraglutide. Importantly, this review may provide a framework to identify responders to other obesity medications. [ABSTRACT FROM AUTHOR]

Summary: Nonalcoholic fatty liver disease (NAFLD) is a growing health concern that is closely related to obesity and metabolic syndrome. In particular, NAFLD has been increasingly reported in adolescents and young adults in recent years. Cardiovascular diseases (CVDs) such as cardiac remodeling, heart failure, myocardial infarction, valvular heart diseases, and arrhythmia are more common in patients with NAFLD. CVD are the major cause of mortality in NAFLD. Although NAFLD often affects patients with obesity/overweight, it can also affect subjects with normal body mass index (BMI), known as lean NAFLD, which has a strong correlation with CVD. Obesity imposes a considerably increased risk of NAFLD and CVD. Consistently, weight‐lowering approaches that can pronouncedly decrease body weight and maintain it in the long term, such as bariatric surgery and treatment with semaglutide and tirzepatide, have been promising in alleviating both CVD and NAFLD. Interestingly, compared with patients with NAFLD and obesity, a minimal amount of weight loss resolves NAFLD in lean patients. Besides the widespread use of bariatric surgery, the development of new GLP‐1 agonists and GLP‐1 GIP agonists revolutionized the treatment of obesity in recent years. Here, we discuss the interwoven correlation between obesity, NAFLD, and CVD and the benefits of weight‐lowering approaches. [ABSTRACT FROM AUTHOR]

Summary: This systematic review evaluated the relationship between macronutrient intake and weight loss after bariatric surgery (BS). The MEDLINE/Pubmed, EMBASE, COCHRANE/CENTRAL, and SCOPUS databases were accessed in August 2021 to search for eligible articles: original publications with adults undergoing BS and indicating the relationship between macronutrients and weight loss. Titles that did not meet these criteria were excluded. The review was written according to the PRISMA guide, and the risk of bias was according to the Joanna Briggs manual. Data were extracted by one reviewer and checked by another. Eight articles with 2.378 subjects were included. The studies indicated a positive relationship between weight loss and protein intake after BS. Prioritization of protein followed by carbohydrates with a lower percentage of lipids favors weight loss and increases weight stability after BS. Among the results found, a 1% increase in protein intake raises the probability of obesity remission by 6%, and high‐protein diet increase 50% weight loss success. Limitations are the methods of included studies and review process. It is concluded that high‐protein intake >60 g a 90 g/day may favor weight loss and maintenance after BS, but it is relevant to balance the other macronutrients. [ABSTRACT FROM AUTHOR]

Summary: Weight‐lowering pharmacotherapies provide an option for weight management; however, their effects on physical activity, function, and cardiorespiratory fitness are not fully understood. We conducted a systematic review and meta‐analysis of randomized controlled trials to investigate the effect of licensed weight loss pharmacotherapies on physical activity, physical function, and cardiorespiratory fitness in individuals with obesity. Fourteen trials met our prespecified inclusion criteria: Five investigated liraglutide, four semaglutide, three naltrexone/bupropion, and two phentermine/topiramate. All 14 trials included a self‐reported measure of physical function, with the pooled findings suggesting an improvement favoring the pharmacotherapy intervention groups (SMD: 0.27; 95% CI: 0.22 to 0.32) and effects generally consistent across different therapies. Results were also consistent when stratified by the two most commonly used measures: The Short‐Form 36‐Item Questionnaire (SF‐36) (0.24; 0.17 to 0.32) and the Impact of Weight on Quality Of Life‐Lite (IWQOL‐Lite) (0.29; 0.23 to 0.35). Meta‐regression confirmed a significant association between pharmacotherapy induced weight loss and improved physical function for IWQOL‐Lite (p = 0.003). None of the studies reported a physical activity outcome, and only one study reported objectively measured cardiorespiratory fitness. Improvements in self‐reported physical function were observed with weight loss therapy, but the effect on physical activity or objectively measured physical function and fitness could not be determined. [ABSTRACT FROM AUTHOR]

Uncertainty exists regarding the relation of body size and weight change with dementia risk. As populations continue to age and the global obesity epidemic shows no sign of waning, reliable quantification of such associations is important. We examined the relationship of body mass index, waist circumference, and annual percent weight change with risk of dementia and its subtypes by pooling data from 19 prospective cohort studies and four clinical trials using meta-analysis. Compared with body mass index-defined lower-normal weight (18.5-22.4 kg/m2 ), the risk of all-cause dementia was higher among underweight individuals but lower among those with upper-normal (22.5-24.9 kg/m2 ) levels. Obesity was associated with higher risk in vascular dementia. Similarly, relative to the lowest fifth of waist circumference, those in the highest fifth had nonsignificant higher vascular dementia risk. Weight loss was associated with higher all-cause dementia risk relative to weight maintenance. Weight gain was weakly associated with higher vascular dementia risk. The relationship between body size, weight change, and dementia is complex and exhibits non-linear associations depending on dementia subtype under scrutiny. Weight loss was associated with an elevated risk most likely due to reverse causality and/or pathophysiological changes in the brain, although the latter remains speculative.

Summary: Tirzepatide is a new glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) that has shown promising results for weight loss. A Bayesian network meta‐analysis was conducted to compare the efficacy and safety of GLP‐1RAs for obesity management. Embase and MEDLINE were searched looking for randomized clinical trials (RCTs) that evaluated the efficacy of GLP‐1RAs for weight loss in patients without diabetes. The main efficacy outcomes evaluated were the mean change in actual and percentage weight loss and the proportion of patients with weight loss of ≥5%–20%. Main safety outcomes evaluated include nausea, vomiting, diarrhea, constipation, loss of appetite, pancreatitis, gallbladder‐related disorders, and withdrawal due to adverse events. Seven RCTs with more than 12,300 patients were analyzed, including patients with body mass index (BMI) ≥ 30 kg/m2, or BMI ≥ 27 kg/m2 with comorbidities. Weekly tirzepatide 10 and 15 mg resulted in more weight loss than weekly semaglutide 2.4 mg, daily semaglutide 0.4 mg, or liraglutide 3 mg. Tirzepatide and weekly semaglutide demonstrated comparable results but with significantly higher odds of achieving ≥5%–20% weight loss compared with liraglutide. GLP‐1RAs triggered more gastrointestinal adverse events than placebo, with no in‐between difference. Although all GLP‐1RAs lead to significant weight reduction, tirzepatide was associated with better efficacy outcomes while having a comparable safety profile. [ABSTRACT FROM AUTHOR]

Summary: Consuming a greater proportion of total energy intake earlier in the day rather than in the evening is proposed to positively influence weight loss and health, potentially due to greater synchronization of human body circadian rhythms. This systematic review provides an update on existing evidence regarding earlier distributed eating patterns in weight loss interventions. Using a robust search strategy in five electronic databases, nine randomized controlled trials investigating the impact of energy intake distribution on weight loss were identified. Following critical appraisal, a random‐effects meta‐analyses found that, in the context of an energy‐reduced diet, distributing energy intake with a focus on earlier intake resulted in significantly greater weight loss (−1.23 kg; 95% CI 2.40, −0.06, p = 0.04). Improvements in HOMA‐IR, fasting glucose, and LDL cholesterol were also seen. The current study provides a timely update on the evidence linking distribution of total daily energy intake and health, showing that a focus on earlier intakes can result in greater short‐term weight loss compared with later intakes. Future studies are needed to elucidate the impact that earlier intakes may have on weight management and metabolic health. [ABSTRACT FROM AUTHOR]

Summary: Research examining weight bias in the bariatric population, who may be at greater risk of weight stigma, is scarce. The present study aimed to systematically review the literature for quantitative evidence that explores the medical, psychosocial, and behavioral sequelae associated with experienced, internalized, and/or externalized weight bias in patients seeking or who have undergone bariatric surgery. Five databases were systematically searched for English peer‐reviewed quantitative studies, which examined weight bias in a sample of individuals seeking or who had undergone bariatric surgery. Risk of bias was assessed. Twenty‐nine studies were included, of which 13 examined internalized weight bias, 12 examined experienced weight bias, 4 examined both, and 0 examined externalized weight bias. Most studies were cross‐sectional, and the results showed high risk of bias. The results suggested that both experienced and internalized weight bias were associated with a host of negative psychosocial, behavioral, and medical sequelae. The findings of this review underscore the need for more rigorous research to better understand the relationship between weight bias and bariatric surgery, particularly longitudinally. Future patients may benefit from research developing interventions for reducing weight bias prior to and following bariatric surgery in order to reduce the associated negative correlates and improve outcomes. [ABSTRACT FROM AUTHOR]

Furthermore, higher prevalence of obesity observed when Asian BMI cut-off point was employed in this present study was in line with the findings from other Asian Pacific populations that indicates the needs to use ethnicity-specific obesity classification in clinical settings to identify obesity and prevent progression to obesity-related health conditions. To address complex sampling, survey weights were used when estimating the prevalence of micronutrient deficiencies (vitamin B12 deficiency; serum vitamin B12 < 145 pmol/L; iron deficiency; ferritin < 30 g/L; and vitamin D deficiency; 25-hydroxyvitamin D < 50 nmol/L) and anemia (hemoglobin < 120 g/L for females and <130 g/L for males) and when assessing associations with logistic regression models with adjusted odds ratios (ORs) for BMI categories: healthy weight (BMI, 18.5 to <25.0 kg/m SP 2 sp ), reference; overweight (BMI, 25.0 to <30.0 kg/m SP 2 sp ), obesity I (BMI, 30.0 to <35.0 kg/m SP 2 sp ), obesity II/III (BMI, 35.0 kg/m SP 2 sp or more). B DISCLOSURE OF INTEREST b : None Declared B LBP57 b B Addressing the Urgent Need in Obesity Care and Management: A Consensus in South and Southeast Asia b K. W. Tham SP 1 sp , M. Fojas SP 2 sp , T. Q. Nam SP 3 sp , B. J. Oldfield SP 4 sp and on behalf of the Working Group on A Consensus on Obesity Care and Management in South and Southeast Asia SP 1 sp I Singapore Association for the Study of Obesity, Singapore, Singapore; i SP 2 sp I University of the Philippines College of Medicine, Manila, Philippines; i SP 3 sp I Ho Chi Minh City University Medical Center, Ho Chi Minh, Viet Nam; i SP 4 sp I Monash University, Melbourne, Australia i B INTRODUCTION: b In South and Southeast Asia (S-SEA) the prevalence of obesity is predicted to double between 2010 and 2030. [Extracted from the article]

B O01 b B Outcomes at 1 year in a community tier 3 weight management service b S. Edwards and P. Gately I Leeds Beckett University, Leeds, UK i B INTRODUCTION: b Obesity continues to be a global issue, and physical, psychological, and social consequences of living with obesity are detrimental to individuals and costly for the health care system. B O13 b B Sex differences in renal and systemic inflammation in a new mouse model of diet-induced obesity and metabolic syndrome b V. Tran, H. Brettle, H. Diep, C. G. Sobey, G. Drummond, A. Vinh and M. Jelinic I Centre for Cardiovascular Biology and Disease Research, La Trobe University, Melbourne, Australia i B INTRODUCTION: b Obesity and metabolic syndrome are leading causes of chronic kidney disease (CKD), and there are major sexual dimorphisms in the development of these metabolic disturbances (i.e., pre-menopausal women with obesity are more prone to developing type-2 diabetes, but men with obesity are more likely to develop CKD). B O38 b B Changes in consumption frequency and purchasing trends of foods prepared at home and outside the home during COVID-19: Results from the international food policy study b S. Dean SP 1 sp , C. Gómez-Donoso SP 1 sp , G. Sacks SP 1 sp , A. Cameron SP 1 sp , C. White SP 2 sp , L. Vanderlee SP 3 sp , M. White SP 4 sp and D. Hammond SP 2 sp SP 1 sp I Deakin University, Geelong, Victoria, Australia; i SP 2 sp I University of Waterloo, Waterloo, Ontario, Canada; i SP 3 sp I Université Laval, Quebec City, Quebec, Canada; i SP 4 sp I University of Cambridge, Cambridge, UK i B INTRODUCTION: b The source of food purchases has an important influence on dietary behaviors. In the 10 countries where foods were detailed, 9 countries had food price policies protecting discretionary foods (including sugars, biscuits, instant noodles, condensed milk and more). [Extracted from the article]