Introduction: Monogenetic obesity involving the POMC and MC4R pathway often result in severe obesity, Case presentation: Two sisters, both in their thirties, with a loss-of-function PCSK1 muta-tion and living with class III obesity (BMI’s 42 kg/m2 and 46 kg/m2, respectively) was referred for obesity treatment. None of the women had obesity-related diseases; however, due to severe obesi-ty they were treated with semaglutide and tirzepatide resulting in weight loss between 16%-27% of initial body weight. Conclusion: Despite a loss-of-function PCSK1 mutation disrupting the POMC pathway, the two cases are suggestive of GLP-1RA efficacy both upstream and downstream POMC, illustrating a need for further investigations of the mechanism of action for GLP-1RA-based therapies.
Introduction: Night shift work is associated with higher risk of overweight/obesity (OW/OB). This study examines the prevalence of OW/OB among current and former night shift workers, compared to day workers, across Europe, and assesses the influence of night shift metrics and lifestyle/psychosocial factors on this relationship. Methods: Data on participants’ self-reported BMI, night shift metrics, sociodemographic, and lifestyle/psychosocial factors were collected via an online survey in Austria, Denmark, Germany, Greece, Italy, the Netherlands, Poland, and Spain (May 2024–January 2025). Logistic regression models analysed the associations between night shift work metrics, lifestyle/psychosocial factors, and OW/OB, accounting for additional adjustments. Results: Among 6,148 Europeans (mean age: 40.6 [10.6] years; 50% female), OW/OB prevalence was highest in Germany and lowest in Denmark (61% vs. 41%; p < 0.001). Current and former night shift workers exhibited higher prevalence of obesity (OR 1.62, 95% CI: 1.33–1.99; OR 1.51 95% CI: 1.19–1.93) than day workers. Longer, more frequent, and rotating night shift exposure correlated with higher odds of OW/OB. Among current night shift workers, factors such as fast eating rate, physical inactivity, and moderate/high alcohol consumption influenced OW/OB prevalence, with unfavourable dietary patterns linked to OB. Adjustments for lifestyle/psychosocial factors had minimal impact on these outcomes. Conclusion: Current and former night shift workers exhibited a higher prevalence of OW/OB than day workers. Lifestyle factors, especially eating rate and physical activity, partly explain this elevated risk. Therefore, prevention strategies could benefit from combining organizational, environmental, and workplace interventions, particularly since an elevated BMI may persist even after night shift work has ceased.
INTRODUCTION:Metabolic-Bariatric surgery is associated with altered ethanol pharmacokinetics and increased alcohol-related risk. While these changes have been described after Roux-en-Y gastric bypass and sleeve gastrectomy, data regarding one-anastomosis gastric bypass (OAGB) have not been reported. This exploratory study evaluated changes in alcohol absorption, elimination, and subjective intoxication following OAGB. METHODS:In this prospective before-after interventional study, adults undergoing OAGB were assessed preoperatively and at 1 and 4 months postoperatively. At each visit, participants ingested 200 mL of red wine (13.5% alcohol by volume; ∼21.3 g ethanol). Breath alcohol concentration (BrAC) was measured at fixed time points over 2 hours using a calibrated breathalyzer. Pharmacokinetic parameters, including maximum concentration (Cmax), time to maximum concentration (Tmax), area under the concentration-time curve (AUC0-inf), and elimination half-life (t1/2), were determined. Subjective alcohol effects were assessed using a standardized symptom questionnaire, and pharmacokinetic-pharmacodynamic relationships were examined. RESULTS:Ten participants (mean age 42 ± 12.8 years; 60% female) were included. Mean Cmax increased from 0.43 ± 0.33 g·L-1 preoperatively to 1.19 ± 0.30 g·L-1 at 1 month and 1.24 ± 0.36 g·L-1 at 4 months postoperatively. AUC0-inf increased from 21.0 ± 15.2 to 71.2 ± 31.5 and 91.2 ± 39.3 g·min·L⁻¹, respectively. Ethanol elimination half-life was prolonged after surgery, and differences remained statistically significant after BMI standardization. Intoxication symptom scores increased postoperatively, and positively correlated with pharmacokinetic parameters, with Cmax having the strongest association. CONCLUSIONS:OAGB alters ethanol pharmacokinetics, leading to higher peak alcohol concentrations, increased systemic exposure, and enhanced subjective alcohol effects. Even modest alcohol intake may potentially lead to high BrAC levels after OAGB, reflecting the need for clinician-led patient education and advice on safer alcohol use after surgery. Given the small sample size, participant attrition, and short postoperative observation period, the study findings should be interpreted with caution.
BACKGROUND:Fast Track to Health was a 12-month intervention for adolescents with obesity and associated complications. Adolescents followed a very low-energy diet (VLED) and intermittent (IER) or continuous energy restriction (CER). This study explored adolescents', parents', and dietitians' perspectives of the intervention. METHODS:A convergent parallel mixed-methods evaluation was conducted. Acceptability questionnaires were collected from adolescents (Week-16: n=113, Week-52: n=88) and parents (Week-16: n=108, Week-52: n=80). Semi-structured interviews were conducted with adolescents (n=14), parents (n=11), and dietitians (n=6) at Week-52. Interview transcripts were thematically analysed. RESULTS:Adolescents rated enjoyability (score 0-100) at Week-16 [Mean (SD) IER: 63.5 (21.1) vs. CER: 65.9 (20.2), p=0.550] and Week-52 [IER: 67.2 (18.1) vs. CER: 61.0 (23.4), p=0.198], showing no significant difference between groups. Most parents reported benefits at Week-16 (IER: 86% vs. CER: 93%, p=0.263) and Week-52 (IER: 79% vs. CER: 83%, p=0.717). Adolescents positively rated their experience with dietitians. Qualitative feedback emphasized the impact of clear dietary advice, easy and frequent access to support, continuity of care, and family engagement. CONCLUSIONS:This evaluation offers insights into a specialised dietary intervention for adolescents. Findings can inform future obesity treatments for adolescents in outpatient tertiary healthcare settings.
BACKGROUND:Childhood overweight and obesity represent a growing global public health challenge. Given the substantial socioeconomic heterogeneity across Asia, a systematic assessment of the disease burden attributable to high body mass index (BMI) in children and its evolving characteristics is critical. Within the GBD 2023 risk attribution framework for children, asthma is the only disease outcome currently included. Therefore, this study focuses on the asthma burden attributable to high BMI in children. OBJECTIVE:To systematically analyze the trends and characteristics of asthma burden attributable to high BMI among children aged 0 14 years in Asia from 1990 to 2050. METHODS:Data on the number of disability-adjusted life years (DALYs) and crude DALY rates (CDR) for asthma attributable to high BMI among children in Asian were obtained from the Global Burden of Disease Study (GBD) 2023. Trends were measured using estimated annual percentage change (EAPC), and future projections were made with a Bayesian age-period-cohort (BAPC) model. Spearman's correlation assessed the link between disease burden and the Socio-Demographic Index (SDI), and a decomposition analysis examined drivers of DALY changes. RESULTS:Children in East Asian had the highest CDR for asthma attributable to high BMI (16.28/100,000) in 2023 and experienced the largest increase from 1990 to 2023 (EAPC=1.57%/year), with future trends projected to rise through 2023-2050 (EAPC=4.49%/year). In high-income Asia Pacific, the 2023 CDR (14.49/100,000) reflected a steady decline since 1990 (EAPC=-0.82%/year). Children in South Asian had the lowest CDR (1.94/100,000). In most countries and territories, the increase in CDR was greater among girls than boys, a sex disparity particularly pronounced in South Asia and Southeast Asia. SDI was positively correlated with the CDR (ρ=0.54, P<0.001) and its EAPC during 1990-2023 (ρ=0.33, P=0.021). Decomposition analysis showed epidemiological change as the main driver of East Asia's rising burden. CONCLUSION:The high BMI-attributed asthma burden in children is most severe and rising fastest in East Asia, while South and Southeast Asia show pronounced sex disparities. These findings provide an epidemiological foundation for targeted prevention and control strategies.
