Obesities

Anorexia nervosa (AN) is characterized by an intense fear of weight gain, dietary restriction resulting in a significant weight loss compared with what is expected, and a disturbance in body image on a psychological basis. Recently, cases of AN associated with food addiction (FA) were described in almost all patients (69%), bringing a controversial aspect to the restrictive subtype (AN-r) that, in theory, even in the absence of binge eating, would present difficulties regarding control. Objectives: To report a case of an adolescent with AN-r associated with FA. Methods: Clinical history, current status, psychiatric diagnosis, and scores on scales to assess FA, food craving, and binge eating were analyzed. Results: This case report emphasizes the importance of new diagnostic tools to identify FA and whether it exists in people with AN-r beyond distress regarding eating behavior, cravings, and guilt. Eating behavior also presents a negative value that delays the elaboration process and the emergence of food cravings. In addition, an analysis of the association between the diagnostic criteria for substance use disorder, binge eating disorder, anorexia nervosa, and bulimia nervosa with the Yale Food Addiction Scale statements and criteria was discovered. Conclusions: Based on the characteristics of AN, emotional dysregulation and eating difficulties seem to overlap with FA symptoms. Full article

Several foods and nutrients are being studied extensively because they have a positive effect on thermogenesis and the browning of white adipose tissue. Therefore, this study aims to evaluate, through a systematic review, the effect of green tea for inducing browning of adipose tissue. The systematic review was built following the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyze. We searched the following electronic databases: PubMed (Medline), Science Direct, Scopus, and Web of Science. We included ten experimental articles that used green tea to treat induced obesity in rodents. Green tea reduced the weight of white and brown adipose tissue, positively regulated gene expression and microRNA that regulate the metabolism of adipose tissue, and morphological changes were identified as beige tissue. According to the results found, the factors involved in this induction to browning are PPARγ, PGC-1α, UCP1, CPT, and PRDM16. Therefore, green tea promotes the browning of adipose tissue in rodents. It is important to emphasize the need for studies in obese humans to identify whether the same metabolic response occurs. Full article

Intermittent energy restricted (IER) diets have become popular as a body weight management approach. In this pilot study, we investigated if an IER diet would reduce systemic inflammation and if maintaining an elevated protein level while on an IER diet would enhance satiety. Six healthy women, aged 33–55 years with a BMI of 27–33 kg/m², were randomized to first adhere to either a low- or high-protein IER diet using whole foods for three weeks. They then returned to their regular diets for a week, after which they adhered to the second diet for three weeks. Each test diet consisted of three low-energy intake days followed by four isocaloric energy intake days. The diets differed only in protein content. High-sensitivity C-reactive protein (hs-CRP), glucose, satiety, body weight, and waist circumference were measured at the beginning and end of each dietary intervention. Most participants showed reductions in hs-CRP levels from baseline on both IER diets but reported greater satiety when adhering to the higher protein IER diet. Overall, the IER diets reduced body weight and appeared to decrease inflammation in these overweight women, and the higher protein version enhanced satiety, which may lead to greater long-term dietary adherence. Full article

There is a lack of research on how perceptions about urban spaces are associated with obesity. We surveyed 347 residents in a rapidly changing area of Detroit, Michigan about their perceptions of urban amenities and the ambient environment. We use principal component analysis to reduce the urban amenity and ambient environment variables to a manageable number. We use a spatial error model to account for spatial autocorrelation. We find that more urban amenities are associated with decreased obesity. A one-percent increase in residents’ perceptions of the availability of urban amenities is associated with a 0.13 percent decrease in obesity. Adverse ambient environments are associated with increased obesity. A one-percent increase in residents’ perceptions of adverse ambient environment quality is associated with a 0.12-percent increase in obesity. Addressing residents’ perceptions about urban spaces can provide planners with an additional tool to tackle obesity. Full article

(1) Introduction: Studies on respiratory muscle strength (RMS) in adolescents are controversial. Few studies so far have investigated respiratory muscle strength in Brazilian adolescents and the impact of body composition on it. (2) Objective: to evaluate the respiratory muscle strength of Brazilian adolescents and compare this with nationally and internationally predicted normality values. (3) Method: A cross-sectional study (CAEE: 34634414.5.0000.5479) was carried out with 98 adolescents, where both sexes were divided into four groups: eutrophic (n = 44); overweight (n = 15), obese (n = 25), and severely obese (n = 14). All were submitted to an anthropometric assessment, body composition analysis and manovacuometry. To interpret the results, Analysis of Variance (ANOVA) with Turkey’s post hoc test was used. The Kruskal–Wallis test and Friedman’s post hoc test were used to compare the observed vs. proposed results. A p-value < 0.05 was considered statistically significant. (4) Results: There were no differences among the groups for maximal inspiratory (MIP) and expiratory (MEP) pressures. However, when considering the total sample, we could say that RMS was higher among boys, and there were no significant differences in RMS in relation to the maturational stage. The values obtained for MIP were lower than those suggested for the national equation and higher than those proposed for the international equation. Similarly, the values obtained for MEP were lower than those suggested for the national and international equation. (5) Conclusions: RMS was similar in adolescents with different body compositions and different maturation stages. Adiposity did not interfere with RMS in adolescents. Boys had higher MIP and MEP values compared to girls. Therefore, the reference values proposed by the equations do not consistently match RMS in the adolescents studied. This context reinforces the need for new studies that are related to RMS to establish normality values and propose equations that represent the youth population. Full article

Our objective was to analyze temporal trends in the prevalence of self-reported hypertension among Brazilian adults and to investigate differences in health behaviors between individuals with and without hypertension between 2006 and 2019. Data from the Surveillance System for Risk Factors and Protection for Chronic Diseases by Telephone Survey were analyzed (n = 730,309). Prais–Winsten regression was used to identify linear trends in the prevalence of hypertension for the entire period (2006–2019) and for the past 5 years. Poisson regression models were used to investigate the differences in health behaviors among individuals with and without hypertension. The prevalence of hypertension (approximately 24.0%) remained stable from 2006 to 2019 and decreased from 25.1% to 24.6% from 2015 to 2019. In the adjusted analyses, individuals with hypertension showed a significant association with unhealthy lifestyle habits: lower recommended intake of fruits and vegetables (APR = 0.97; p = 0.022), lower regular intake of fruits (APR = 0.98; p < 0.001), lower regular intake of beans (APR = 0.97; p < 0.001), lower leisure-time exercising (APR = 0.89; p < 0.001), higher abusive consumption of alcoholic beverages (APR = 1.04; p = 0.004), higher prevalence of overweight (APR = 1.40; p < 0.001), and higher prevalence of obesity (APR = 2.17; p < 0.001). Hypertension prevalence has remained stable during the entire period and decreased in the most recent period. Individuals with hypertension reported unfavorable scenarios for healthy habits. Full article

Undertaking a home-based exercise programme should be a positive, health-enhancing lifestyle behaviour, particularly for adults living with overweight and obesity. However, exercise programmes are seldom designed in collaboration with people with lived experience, limiting adherence, efficacy, and effectiveness. Two focus groups (in-person n = 6 and virtual n = 7) were undertaken in the United Kingdom, to glean feedback and further refine a home-based exercise programme, developed from previously conducted semi-structured interviews with adults living with overweight and obesity. Both focus groups provided an opportunity for participants to discuss the proposed programme, highlighting strengths and areas for further improvement. Three key priorities were identified for consideration throughout the design process, specifically for adults living with overweight and obesity: (1) individualisation—a person-centred programme was non-negotiable; (2) motivation—integration of motivational features affected adherence and engagement; (3) more than just weight loss—consideration of other outcomes aside from solely numerical weight loss. These priorities provide direction for further refinement of the proposed home-based exercise programme, in an effort to ensure the final intervention is truly population-specific and needs-sensitive. Following completion, the programme will be assessed using a feasibility randomised controlled trial design. Full article

The aim of this study was to analyze the trend of severe obesity in the capitals of the Brazilian states and the Federal District, from 2006 to 2021. For this purpose, a time-series, population-based, observational study was designed using data from the VIGITEL Survey. The dependent variable of this study was the prevalence of severe obesity, which was defined as a body mass index ≥ 40 kg/m². Time series analysis was conducted using Joinpoint Regression Analysis Software v.4.9.1.0. In this study, a normal distribution was assumed, and the average annual percentage change (AAPC) and 95% confidence intervals (95% CIs) were presented. In total, 778,445 individuals participated in the study (38.2% were male and 61.8% were female). The prevalence of severe obesity has increased from 1.1% in 2006 to 1.9% in 2021. The average annual percentage change indicates an upward trend for the period (AAPC: 4.7; 95% CI: 3.8; 5.7). When stratifying the trend of severe obesity by sex, a significant upward trend was observed for females (AAPC: 4.3; 95% CI: 1.9; 6.8). There was a significant upward trend for all age groups, skin colors, and education levels. However, the older age groups and those with less education had lower AAPC. Full article

Beyond being painful, fat stigma might facilitate pernicious consequences; over and above one’s weight, fat stigma is associated with lesser wellbeing, poorer health, greater all-cause mortality, and weight gains that perpetuate the weight-stigma cycle. To combat fat stigma effectively requires an understanding of the perceptual calculus underlying it. Here, we seized upon new work asserting that importance of a previously overlooked variable in this calculus—fat deposition location (body shape)—and we examine basic but fundamental open questions about the role of body shape in fat stigma via two experiments (one pre-registered). We replicate and extend work investigating how body shape—over and above body size—drives stigma toward women, using a figure set created specifically to test predictions about the role of body shape as well as size. We asked: (1) Are findings of greater explicit stigma toward adult women with abdominal (gut) versus gluteofemoral fat depositions (hips, thighs, buttocks) replicated—and (2) does this same finding hold for implicit stigma?; (3) Are male targets similarly stigmatized as a function of shape? (4) Do individual difference factors known to predict anti-fat stigma, e.g., Protestant Work Ethic, play a role here? We examined these questions by presenting American participants with women and men targets varying in both body size and shape—assessing participants’ explicit stigma (via self-report) and implicit stigma (via the Attitude Misattribution Procedure; AMP). We replicated the pattern that explicit fat stigma toward women is shape-sensitive and extend that to implicit stigma—finding, for example, that, of two women with the same exact heights and higher weights, the woman with abdominal fat deposition is more stigmatized than the woman with gluteofemoral fat deposition. We found no consistent results regarding the role of body shape in driving fat stigma toward men. We also found that some individual difference factors predicting anti-fat stigma were also attuned to body shape as well as body size. The results underscore the importance of integrating body shape into future work on fat stigma (toward women). Full article

Background: This study analysed through the perspective of networks the association between physical activity (PA), sedentary behaviour (SB), and cardiovascular risk factors in overweight low-income schoolchildren from the perspective of complex systems. Methods: The sample consisted of 41 overweight children between 6 and 10 years old (56% girls). PA and SB were analysed by accelerometer, and the measures of cardiovascular factor risk were: anthropometric and hemodynamic measurements, body fat, lipid profile and glucose, cardiorespiratory fitness (CRF), left ventricular mass (LVM), and Sokolow–Lyon. Network analysis with Bootstrap-1000 was performed to analyse the association between PA, SB and the cardiovascular risk factors. Results: Moderate-to-vigorous PA was positive related to waist circumference (WC; 0.499), HDL-C (0.307), and CRF (0.276), and negatively associated with BMI (−0.251) and Fat (−0.341). For SB, positive associations were seen with WC (0.326), CRF (0.296), LVM (0.250) and Sokolow (0.215). In addition, the centrality indicators highlighted WC as the most important variable in the network. Conclusion: Interventions that aim to mitigate the harmful effects of obesity on cardiovascular risk factors in overweight children should consider WC as an important variable in the system. Full article

We aimed to identify the temporal trend of multimorbidity of noncommunicable disease (NCDs) among Brazilian adults (n = 784,479) over a 16-year period of time. This is a time series of cross-sectional studies based on data from the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) from 2006 to 2021. The presence of multimorbidity was assessed from the co-occurrence of (1) obesity and diabetes; (2) obesity and hypertension; and (3) obesity and diabetes and/or hypertension. Linear regression models (Prais–Winsten) were used to identify significant trends for the complete period (2006–2021) and the most recent quinquennium (2017–2021). Multimorbidity of obesity and diabetes and/or hypertension increased in the complete period (5.5% to 9.6%; 0.22 pp/year) and the most recent period (8.3% to 9.6%; 0.40 pp/year) studied. The highest increase occurred especially among men, older adults, and those with fewer years of education. Additionally, there was a high prevalence and an intense increase in multimorbidity among adults with poor self-rated health. These results reinforce the need for expanding and strengthening public health actions focused on individuals with multimorbidity especially with obesity. Full article

Mounting evidence links obesity, metabolic dysfunction, mood, and cognition. Compromised metabolic health and psychological functioning worsen clinical outcomes, diminish quality of life, and contribute to comorbid conditions. As a medication with both insulin-sensitizing and anti-inflammatory effects, metformin affords the exciting opportunity to abrogate the bidirectional relationship between poor metabolic health and psychological function. In the current paper, we review the literature linking metformin to mood and cognitive function, examine potential underlying mechanisms, and suggest new directions for investigating the role of metformin in increasing adherence to health behavior recommendations. Full article

Obesity is one of the most pressing healthcare concerns of the twenty-first century. Obesity prevalence has risen dramatically in recent decades, and in 2016, more than 1.9 billion adults were overweight (BMI ≥ 25 kg/m²) and 650 million were obese (BMI ≥ 30 kg/m²). About 50% of the world’s population is anticipated to be obese/overweight within the next decade. Obesity is a major risk factor for a variety of non-communicable diseases, including type 2 diabetes mellitus, cardiovascular disease, non-alcoholic fatty liver disease, and a variety of malignancies. Obesity has emerged as a substantial risk factor for hospitalization and death from viral respiratory infections such as influenza A and the ongoing pandemic SARS-CoV-2. Several independent studies have indicated that obese/overweight patients are at a higher risk of severe disease and death from these respiratory diseases. Excess fat, particularly visceral fat, contributes to the development of a variety of metabolic disorders, including persistent systemic inflammation and decreased immunological function. As a result, the immunological response to infectious pathogens is weakened, resulting in poorer outcomes post-infection. Additionally, the poor lung mechanics associated with obesity may increase the risk of more serious respiratory infections. In this review, we address the likely mechanism(s) that predispose obese people to severe diseases caused by viral respiratory infections. Full article

The present study aimed to verify the associations between compliance with the 24-h movement behavior recommendations, fitness, and adiposity markers in preschoolers, considering the non-linear nature of these associations. The sample was comprised of 253 preschoolers. Preschoolers were assessed for anthropometric data and wore an accelerometer for seven consecutive days. Screen time and sleep duration were parent-reported in a face-to-face interview. The PREFIT test battery was used to assess physical fitness components (lower-body strength, cardiorespiratory fitness, and speed/agility). Descriptive statistics were used to describe the variables, and a network analysis was conducted to assess the emerging pattern of associations between the variables. Preschoolers’ greatest compliance with recommendations was observed for physical activity, while the lowest compliance was observed for the screen time recommendation. Among children aged three years, only 2.2% complied with all recommendations; only 1.0% of the four-year-olds and 1.3% of the five-year-olds complied with all recommendations. The results of the network analysis and centrality measures emphasized that cardiorespiratory fitness (CRF) and compliance with movement behavior recommendations were the most critical variables to address in preschoolers, reinforcing the importance of intervention programs focused on intense activities. Full article

Obesity is a chronic disease affecting both adults and children worldwide. One major cause of obesity is high-calorie intake due to overconsumption of foods rich in fat and carbohydrates. Hence, obesity can be controlled by controlling the diet and by other lifestyle changes that increase energy expenditure. However, this is not always possible for individuals who are already overweight and suffering from other diseases. Therefore, certain drugs have been developed to assist with weight reduction. One major avenue for drug development involves the inhibition of enzymes that break down fat and carbohydrates from the diet. This can reduce the bioavailability and absorption of dietary lipids and carbohydrates, allowing for the management of obesity. Although there are synthetic drugs available on the market to inhibit these enzymes, plant-based natural drugs may provide a better alternative to treat obesity due to fewer side effects and a lower cost. In this review, different methods that can be used to screen medicinal plant extracts for inhibitors of those digestive enzymes and certain limitations of those methods are discussed. Currently, there is limited research on the effects of varying conditions on enzyme assays, and this is an area that can be addressed in future research. Full article

There is a need for identifying whether simple techniques for estimating visceral fat can accurately predict inflammatory and cardiometabolic disease (CMD) biomarkers in various populations. We aimed to determine whether a simple estimate of visceral fat area by multifrequency bioelectrical impedance analysis (MFBIA) was independently associated with multiple biomarkers of inflammation and CMD. Seventy-eight men and women (mean ± SD: age 52.0 ± 10.8 y; visceral fat area 105.6 ± 55.0 cm²) self-reported their medical histories and activity levels. Visceral fat area was estimated with MFBIA, CMD and inflammatory biomarkers were measured by fasting blood draw, and homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. Associations were assessed using multivariable linear regression. With adjustment for age, sex, height, race/ethnicity, family history of diabetes, and smoking, a 1-standard deviation (1-SD) increase in visceral fat (55 cm²) was associated with higher levels of insulin (60.4%), triglycerides (43.6%), C-reactive protein (38.7%), interleukin-6 (33.9%), leptin (77.9%), and HOMA-IR (51.8%, p < 0.01 for all). These associations were attenuated but remained significant when physical activity and sedentary behavior were entered into the model (p ≤ 0.01). These findings suggest that a simple estimate of visceral fat area by MFBIA may be a good indicator of increased CMD risk and may be useful in clinical practice. Full article

Orange juice contains flavanones, which are associated with reducing the risk of obesity-associated diseases. We evaluated the effects of two varieties of orange juices on the oxidative stress, inflammatory response, and gut microbiota of individuals with insulin resistance and different obesity classes. In a randomized crossover study, obese patients consumed ‘Pera’ (POJ—source of flavanones) and ‘Moro’ (MOJ—source of flavanones and anthocyanins) orange juices for 15 days. Blood, urine, and fecal samples were collected before and after the intervention. Daily orange juice intake significantly reduced HDL and total cholesterol, in addition to urinary 8-OHdG and plasmatic MCP-1 levels. Multivariate analyses highlighted the beneficial effects of orange juice intake, mainly the modulation of inflammatory and oxidative stress biomarkers. Patients in different obesity classes presented a gut microbiota with obesity-associated alterations (dysbiosis), and the consumption of Pera and Moro orange juices improved this profile by modulating their gut microbiota in different ways. Although the Firmicutes/Bacteroidetes ratio changed after both interventions, MOJ provided more accentuated changes than POJ. Blautia, Bifidobacterium, and other genera had their relative abundance altered by juice consumption, which correlated with patient parameters (such as HDL-cholesterol and diastolic blood pressure) and biomarkers (such as TNF-α and 8-OHdG). In conclusion, regular orange juice intake can be associated with a reduction in oxidative stress and inflammatory response, in addition to modulating gut microbiota. Full article

(1) Background: Obesity is a global epidemic issue that has increased greatly in recent decades. Although interventions such as nutritional approaches and the practice of physical exercise are potential therapies to combat obesity, in some cases they are not sufficient. Therefore, the development of new pharmacological treatments is necessary. Combining these therapies with non-pharmacological alternatives could be an interesting strategy for treating obesity. Considered a pharmacological treatment for overactive bladder (OAB), mirabegron is also categorized as a β(3)-adrenoceptor agonist, and is used in recommended doses of 25 mg and 50 mg. Animal models have shown that the administration of 0.8 mg/kg of mirabegron leads to elevated activation of brown adipose tissue (BAT) and white adipose tissue (WAT) browning. (2) Results: Findings suggest that the pharmacological application of mirabegron has numerous beneficial effects in lipid metabolism, suggesting a potential action against obesity. In this context, physical exercise and mirabegron stimulate browning activation using different mechanisms. (3) Conclusions: According to the results of the studies presented in this review, mirabegron may be a promising pharmacological treatment for obesity due to its significant effects on estimated energy expenditure (EER) through thermogenesis elevation, BAT activation, and WAT browning seen in dosages up to 100 mg. In addition, the administration of mirabegron combined with physical exercise may be a potential alternative for increasing the body’s energy expenditure, with actions in distinct signaling pathways. Thus, physical exercise combined with mirabegron can alleviate some adverse side effects encountered with the use of the medication. Finally, although there have been advances in knowledge, more studies are needed to understand the combined effects of using mirabegron and physical exercise. Full article