Objective Food noise has been studied with GLP-1-based therapies, but not with metabolic bariatric surgery (MBS), despite shared mechanisms. Data on food noise beyond initial weight loss are limited, and weight self-stigma (WSS), which links to poorer weight outcomes and risky behaviors after MBS, may relate to higher food noise, especially during weight stabilization. This study investigates whether WSS is associated with increased food noise during stable weight following MBS.Methods Adults who remained weight stable following MBS completed the Weight Self-Stigma Questionnaire (WSSQ) and Food Noise Questionnaire (FNQ). Multivariable linear regression examined associations between WSSQ scores (total and self-devaluation/fear of enacted stigma subscales) and FNQ scores.Results Participants (n = 60) were 13.3 +/- 4.5 months post surgery, with a maximum weight loss of 24.8% +/- 8.4%. Higher WSSQ total (B = 0.29, p = 0.001) and self-devaluation subscale (B = 0.36, p = 0.021) scores were associated with higher FNQ scores.Conclusions Food noise increased with higher WSS, particularly among individuals reporting greater self-devaluation due to weight during postoperative weight stability. Further research should map this relationship across postoperative weight stages, test causal direction, and identify mechanisms. Because WSS and food noise can undermine health behaviors, weight loss, and health gains after MBS, routine screening and integrated clinical interventions may be warranted.
Objective High-fat diet represses Ceacam1 transcription via a PPAR alpha-mediated mechanism to cause insulin resistance before inflammation develops. The current study investigated whether mutating PPRE-RXR alpha in Ceacam1 promoter prevents diet-induced metabolic abnormalities and hepatic fibrosis in male C57BL6/J mice.Methods A knock-in mouse line (KI) bearing mutation on PPRE-RXR alpha in Ceacam1 promoter was generated. Male mice were fed with regular chow, high-fat diet, or GAN diet for 1-4 months before insulin action was assessed in vivo by hyperinsulinemia-euglycemia clamp analysis and energy balance was analyzed by indirect calorimetry. H&E and Sirius Red staining were carried out to detect steatohepatitis and hepatic fibrosis, respectively.Results Feeding with high-fat or GAN diet for 1-4 months repressed hepatic CEACAM1 expression in wild-type but not KI mice. Mutating PPRE-RXR alpha prevented diet-induced impairment of insulin clearance to maintain normoinsulinemia and insulin sensitivity. High-fat diet failed to reduce energy expenditure and spontaneous locomotor activity in KI, as it did in wild-type mice. GAN feeding for 4 months caused mounting of a Th1-inflammatory response and hepatic fibrosis in wild-type but not KI mice.Conclusions Blocking CEACAM1 repression while maintaining endogenous regulatory mechanisms and normal physiologic conditions sufficed to curb diet-induced metabolic dysregulation, steatosis, energy imbalance, and MASH progression.
Objective This study evaluated temporal trends and patient characteristics associated with glucagon-like peptide-1 (GLP-1) receptor agonist prescribing among US adults without an apparent FDA-approved indication.Methods This retrospective cohort study used Cosmos electronic health records (01/2021-12/2025). Adults prescribed liraglutide, semaglutide, or tirzepatide without a documented indication (type 2 diabetes or obesity with qualifying comorbidities) were included. Patients without a recorded weight >= 6 months prior to first prescription were excluded. Demographic and clinical characteristics were compared using t-tests and chi 2 tests.Results Among 92,415,648 adults without an apparent FDA-approved indication, 1,133,953 (1.2%) were prescribed GLP-1 receptor agonists. Prescribing increased from 0.1% in 2021 to 1.5% in 2025 (15-fold). Recipients had higher median BMI (25.9 vs. 24.5 kg/m2) and were more often female (85.5%) and White (60.0%). Hypertension and dyslipidemia were more common, while coronary artery disease and heart failure were less prevalent. Notably, 35.1% had normal BMI; eating disorders were more frequent (1.8% vs. 0.3%). GLP-1 receptor agonist use was associated with lower social vulnerability and private insurance.Conclusions GLP-1 receptor agonist prescribing without an apparent FDA-approved indication has increased rapidly and disproportionately involves socioeconomically advantaged populations, including individuals without obesity. The risk-benefit profile in these populations remains uncertain.
