obesity

Overview

Obesity is a chronic, progressive disease characterized by excess adiposity that adversely affects health. Clinically, it is commonly defined using body mass index (BMI), with obesity typically corresponding to BMI ≥30 kg/m², although body-fat distribution and obesity-related complications are increasingly recognized as important for risk stratification. Obesity is associated with insulin resistance, low-grade systemic inflammation, dyslipidemia, hypertension, type 2 diabetes, metabolic dysfunction-associated steatotic liver disease (MASLD), cardiovascular disease, heart failure, sleep apnea, infertility, and several pregnancy-related complications.

Biologically, obesity reflects a complex interaction among genetic susceptibility, epigenetic regulation, diet, physical activity, endocrine signaling, gut microbiota, and adipose tissue dysfunction. Recent research has emphasized pathways involving GLP-1 receptor signaling, GIP/GLP-1 co-agonism, leptin and adiponectin biology, AMPK/TBK1, NF-κB, TLR4/MyD88, and other metabolic and inflammatory circuits. Because obesity influences multiple organ systems, it is both a disease entity in its own right and a major modifier of outcomes across surgery, transplantation, cardiometabolic disease, reproductive health, and cancer.

Focus of Latest Publications

Recent publications portray obesity as a central clinical and mechanistic target across metabolic disease, surgery, and precision therapeutics. Several studies focused on anti-obesity pharmacotherapy, especially incretin-based agents. A phase 2 trial of elecoglipron, an oral small-molecule GLP-1 receptor agonist, evaluated adults with obesity or overweight, including those with type 2 diabetes, as part of weight-management development. Other work examined semaglutide in real-world and trial settings, including cardiometabolic outcomes in people with type 2 diabetes in the United Arab Emirates, insulin-dose reduction in adults with type 1 diabetes and obesity, and a post hoc analysis of body-composition effects suggesting that GLP-1 medicines improve body composition without disproportionate loss of muscle mass or function. tirzepatide was also studied in multiple contexts, including recurrent weight gain after bariatric procedures, shifts in waist-to-height ratio categories in SURMOUNT-1, and a protocol for treatment of obesity in type 1 diabetes. A phase 2 randomized trial of bimagrumab plus semaglutide further reflects interest in combination approaches for obesity treatment. In parallel, a phase 3 trial of survodutide in adults with obesity and at-risk MASLD highlighted the overlap between obesity and liver disease.

Other studies explored obesity as a modifier of surgical and procedural outcomes. In robotic urologic surgery, obesity was examined in relation to pyeloplasty outcomes, partial nephrectomy complexity, and perioperative GLP-1 receptor agonist use. In bariatric surgery, investigators assessed long-term diabetes remission and medication costs compared with medical therapy, postoperative complications in pediatric patients, and the influence of bariatric procedures on male sex hormones and semen parameters. Obesity was also linked to body contouring demand after bariatric surgery and GLP-1 receptor agonist use. In transplant medicine, GLP-1 analogue use was evaluated for weight trajectory and outcomes after liver transplantation.

A major theme across the literature is obesity’s cardiometabolic burden. Studies connected obesity with coronary artery disease risk, heart failure with preserved ejection fraction, albuminuria in non-diabetic severe obesity, cardiac structure and function in children with obesity and metabolic syndrome, and cardiovascular-kidney-metabolic syndrome. Obesity was also discussed as a risk factor for preeclampsia and eclampsia, with attention to variation by race and ethnicity, and as a contributor to gestational diabetes-related risk in pregnancy. In pediatric and adolescent populations, obesity was associated with quality-of-life impacts, olfactory changes after inpatient weight loss, obesity-related cerebral iron overload and perfusion alterations, and the need for school- and community-based prevention programs.

Several studies addressed obesity-related inflammation, metabolism, and tissue biology. Adiponectin was shown to vary inversely with obesity in the context of caloric restriction. Obesity-related insulin resistance and skeletal muscle metabolism were examined in relation to the unfolded protein response. Other work investigated obesity-associated pain, obesity-related changes in oxylipins in HFpEF, and obesity-linked alterations in vitamin D status, CYP1A2 activity, and hepatic metabolism. Experimental studies in mice and cell systems examined mechanisms such as NF-κB signaling, TLR4/MyD88/NF-κB, CB2 receptor-mediated antinociception, AMPK/TBK1 disruption, and GIPR:GCGR co-agonism restoring normal weight in obese rodents. Additional preclinical studies evaluated compounds and natural products with anti-obesity effects, including adzuki bean saponin, mulberry leaf extracts, Capsosiphon fulvescens extract, Rhus verniciflua, 6-benzylaminopurine, and various traditional Chinese medicine formulations.

Obesity was also studied as a determinant of reproductive, endocrine, neurologic, and psychosocial outcomes. It was associated with infertility, repeated ovulation induction needs, and altered semen quality. In neurology, obesity was linked to idiopathic intracranial hypertension and to cognitive impairment in imaging studies. Mental health and quality of life were recurrent themes, including alexithymia-depression associations, Health-Related Quality of Life, and digital self-monitoring interventions in people with mental disorders. Population studies and surveys emphasized that obesity remains underdiagnosed and undertreated in routine care, with substantial clinical and economic burden.

Key Publications

• NEWJun Navigating the challenge: does obesity compromise outcomes in single-port robot-assisted pyeloplasty? (Journal of robotic surgery, 2026, PMID 42324413): "Patients were classified into three groups according to World Health Organization BMI categories: normal weight (BMI < 25 kg/m²), overweight (25 ≤ BMI < 30 kg/m²), and obese (BMI >= 30 kg/m²)."
• NEWJun Association between COVID-19 booster vaccination and influenza mortality: a nationwide retrospective cohort study using the SIVEP-Gripe database in Brazil. (Immunologic research, 2026, PMID 42324378): "Additional risk factors included dyspnea, respiratory distress, and low oxygen saturation, as well as comorbidities such as obesity, diabetes, liver disease, and immunosuppression."
• NEWJun Elecoglipron, an oral small molecule GLP-1 receptor agonist in adults with obesity or overweight (VISTA): a multicentre, phase 2, randomised, placebo-controlled clinical trial. (Lancet (London, England), 2026, PMID 42259337): "...in development for weight management in people living with obesity or overweight and type 2 diabetes."
• Jun Adiponectin exerts sex-dependent effects on lipid, amino acid, and glucose metabolism during caloric restriction. (PLoS biology, 2026, PMID 42313833): "Plasma adiponectin decreases in obesity but increases in leanness, including during caloric restriction (CR) in animals and humans."
• Jun Anatomy and patient comorbidity in robotic partial nephrectomy: predictors of complexity and outcomes. (Journal of robotic surgery, 2026, PMID 42319664): "The formal PADUA × Obesity interaction term was non-significant (β=0.34, 95% CI-0.88 to 1.56, p=0.585)."
• Jun Changes in olfactory function in children and adolescents with obesity following an inpatient weight loss program: a longitudinal study. (BMC medicine, 2026, PMID 42310628): "Obesity is a major global public health burden, yet the mechanisms underlying interindividual variability in treatment response remain poorly understood."
• Jun Identifying MicroRNA Biomarkers in Idiopathic Intracranial Hypertension: A Pilot Study. (Neurology, 2026, PMID 42308437): "It predominantly affects women with obesity and can cause disabling headaches and permanent visual loss."
• Jun The evolving therapeutic landscape of gut-pancreatic peptide signalling in metabolic disorders: from mono- to multi-agonist therapies. (Bioscience reports, 2026, PMID 42307179): "The pharmacotherapeutic landscape for the clinical management of type-2 diabetes (T2D), obesity, metabolic dysfunction-associated steatotic liver disease (MASLD), and steatohepatitis (MASH) is evolving swiftly in response to the escalating global prevalence and incidence of these interrelated metabolic disorders."
• Jun Correlation between serum 25-hydroxyvitamin D levels and cardiac structure and function in children and adolescents with obesity combined with metabolic syndrome. (Nutricion hospitalaria, 2026, PMID 41503839): "the aim of this study was to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and echocardiographic indices in children and adolescents with obesity combined with metabolic syndrome (MetS)."
• Jun Preeclampsia and Eclampsia: A Complex Interplay Between Prepregnancy Obesity, Race, and Ethnicity. (Journal of the American Heart Association, 2026, PMID 42294754): "Prepregnancy obesity is a well-established risk factor, but the variation of its association with PE/E by race and ethnicity, particularly among Asian/Pacific Islander (PI) and Hispanic subpopulations, remains unclear."