The ketogenic diet (KD) is a metabolic intervention characterized by high fat and very low carbohydrate intake, showing significant metabolic, neuroprotective, and therapeutic effects. However, its efficacy varies widely due to individual genetic and epigenetic factors. This review synthesizes current knowledge of genes most strongly associated with KD response, including polymorphisms in FTO, APOA2, PPAR, SCN1A, KCNQ2, STXBP1, CDKL5, the MODY gene group, and SLC2A1, which shape outcomes across lipid metabolism, energy expenditure, inflammation, and neurotransmission. Epigenomic modifications induced by a KD, such as changes in DNA methylation and histone acetylation involving BDNF, SLC12A5, KLF14, and others, modulate functional metabolic and neurological effects. Sex and age further modulate KD effects through distinct patterns of gene activation and hormonal interactions. These variables together impact metabolic and neurological outcomes and are critical for developing personalized nutrition and disease management strategies. Based on the reviewed evidence, genetic and epigenetic profiling can help identify patients who are likely to benefit from a KD (e.g., GLUT1DS, PDH deficiency) and those in whom a KD may be ineffective or harmful (e.g., SCOT or SLC2A1-independent defects). The review concludes that genetic and epigenetic profiling is recommended for personalized dietary interventions.

Background/Objectives: Obesity is a major risk factor for cardiovascular disease (CVD), but traditional risk calculators such as Systematic COronary Risk Evaluation (SCORE2) may not fully capture the elevated risks in individuals with obesity, especially when metabolic health is considered. This study aimed to evaluate the effectiveness of QRESEARCH risk estimator version 3 (QRISK3) in estimating 10-year cardiovascular risk in individuals with varying obesity phenotypes compared to SCORE2. Methods: A total of 88 participants (25 men, 63 women; mean age 37.4 ± 11.8 years) were categorized into four obesity phenotypes according to metabolic and anthropometric criteria. The 10-year CVD risk was calculated using SCORE2 and QRISK3 algorithms. Functional cardiovascular assessment included blood pressure (BP) measurement and electrocardiogram (ECG) interpretation for conduction abnormalities and left ventricular hypertrophy (LVH). Biochemical analysis included carbohydrate metabolism (fasting glucose, postprandial glucose, HbA1c) and lipid profile (total cholesterol, LDL-C, HDL-C, triglycerides, atherogenic index). Results: SCORE2 underestimated CVD risk (3–8%), whereas QRISK3 predicted higher values (6–16%), particularly in metabolically unhealthy phenotypes. LVH occurred in 26–45% of participants, with elevated BP and early subclinical ECG changes even in metabolically healthy obesity individuals. Carbohydrate metabolism disturbances were observed in metabolically unhealthy participants with normal or elevated BMI, while lipid abnormalities—including elevated total cholesterol, LDL-C, triglycerides, and atherogenic index—were prominent in these metabolically unhealthy phenotypes. Insulin resistance, assessed via the triglyceride–glucose index, exceeded reference ranges in all obesity phenotypes, with the highest values seen in metabolically unhealthy individuals. Conclusions: QRISK3 provides a more precise and thorough assessment of 10-year cardiovascular risk in individuals with obesity than SCORE2. These findings highlight the importance of incorporating anthropometric and metabolic data into cardiovascular risk assessments and support the clinical use of QRISK3 for more personalized risk stratification, especially in populations with obesity and metabolic disturbances. Early identification of high-risk individuals using QRISK3 could lead to more timely and targeted preventive interventions, improving long-term cardiovascular outcomes.

Background and Objectives: Previous research shows that stress can alter eating habits. This study analyzed the impact of COVID-19 confinement on eating behaviors and weight in Spanish adults, as well as related factors. Methods: A total of 2834 adults (69.3% women, Mean age: 41.36) completed an online questionnaire assessing eating habits, weight, and sociodemographic variables. Results: Strict lockdown in Spain was linked to a general worsening of eating habits, particularly increased food intake and weight gain. Risk factors for less healthy eating and weight gain included being female (p < 0.001), under 35 years old (p < 0.001), overweight or obese (p < 0.001), caring for minors (p = 0.002), and experiencing nervousness or anxiety (p < 0.001). Conversely, maintaining pre-confinement eating habits and weight was more common among men (p < 0.001), individuals aged 50 years or older (p < 0.001), those with normal or underweight BMI (p < 0.001), those working outside the home (p < 0.013), and those without minors in their care (p = 0.001). Conclusions: Prolonged lockdowns associated with high stress may negatively influence diet and weight. Prevention strategies should therefore promote healthy eating during such periods, particularly targeting groups at higher risk of worsening habits and weight gain.

Obesity is a medical issue of increasing prevalence, with emotional eating being a key contributor to the problem, particularly in women. Theory and previous research suggest that obesity treatment participants’ self-regulatory abilities and self-efficacy to control eating are viable targets for improving emotional eating and related impacts on an unhealthy body composition. However, an improved understanding of interrelations between self-regulatory and self-efficacy changes are needed to inform behavioral treatments, which have had mostly negligible effects beyond the short term. Women were randomized into 6-month community-based obesity treatment conditions of (a) cognitive–behavioral methods with attention on emotional eating (n = 48), (b) cognitive–behavioral methods with no specific attention on emotional eating (n = 48), and (c) weight loss education (n = 50). Study-related improvements were greater in the merged cognitive–behavioral condition (n = 96; aggregated because the two corresponding treatment conditions demonstrated no significant differences). Using data aggregated across all study participants, early change in eating-related self-regulation was a significantly stronger predictor of longer-term change in eating-related self-efficacy than vice versa. Consistent with that finding, paths from treatment condition→change in self-regulation→change in self-efficacy→change in emotional eating over both 6 and 12 months were significant but not where change in self-efficacy was, instead, entered as a predictor of self-regulation change. Lessened emotional eating was significantly associated with concurrent reductions in weight and waist circumference. Consistent with self-regulation theory, findings suggest benefits for cognitive–behavioral obesity treatments over the more common education-based approaches, as well as benefits for first focusing on self-regulation that could empower increases in self-efficacy. Consistent with self-efficacy theory, such induced increases might promote favorable behavioral changes.

The stages of change have been identified as a valuable framework for understanding the transition toward a healthy lifestyle. It is also important to recognize change through other psychosocial variables, such as motivation and self-efficacy. The objective of this study was to explore weight control over the course of an academic year (nine months) through three behaviors: the stage of change toward weight control (pre-contemplation, contemplation, preparation, action, maintenance), healthy and unhealthy eating behaviors for weight control, and the frequency of physical activity (PA). Furthermore, we wanted to ascertain whether the three distinct types of motivation (autonomous, controlled, and amotivation) and self-efficacy could account for fluctuations in weight control over time. The sample consisted of 303 adolescents (205 female and 98 male) between the ages of 15 and 23 (M = 17.26; SD = 1.65). Chi-square, t-test, and multiple linear stepwise regression analysis were employed. The results indicated that a higher proportion of adolescents were in the precontemplation and action stages at Time 2. Concurrently, an increase in the frequency of moderate-to-vigorous PA and an increase in healthy and unhealthy behaviors were observed during the school period. The present study posits that autonomous motivation, controlled motivation, and self-efficacy can explain healthy eating behaviors for weight control and the frequency of moderate-to-vigorous PA, while only controlled motivation explains unhealthy eating behaviors for weight control. The conclusion of the study points out that healthy behaviors can change over time due to individual regulation of motivation and increased self-perception of efficacy in one’s own abilities to perform a specific action to control weight.

Obesity has emerged as one of the most significant public health challenges of the 21st century, with its prevalence increasing at an alarming rate globally. While individual factors such as diet and physical inactivity are well-known contributors, the built environment, particularly housing, plays a critical yet understudied role in shaping obesity-related behaviors. This study examines the multilayered relationship between housing and obesity, focusing on built and neighborhood environment, affordability, and the social environment. Poor housing quality, such as overcrowding and inadequate ventilation, can potentially lead to chronic stress and sedentary behaviors, while housing design influences physical activity through characteristics such as design features and outdoor spaces. Housing location affects access to amenities such as parks and healthy food options, with disparities in access contributing to obesity in low-income areas. Similarly, neighborhood walkability, influenced by infrastructure and land use, encourages active transportation and recreation. Housing affordability also impacts dietary choices and access to recreational facilities, particularly for low-income families. Moreover, the social environment within housing communities can foster or hinder healthy behaviors through social networks and community engagement. This study emphasizes the need for health-conscious urban planning and policies that address these housing-related factors to combat obesity and promote healthier lifestyles. By integrating these Obesity–Housing Nexus, policymakers can create environments that support physical activity, healthy eating, as well as overall health and well-being.

Introduction: Subclinical atherosclerosis is increasingly recognized in younger populations, often progressing silently until the onset of overt cardiovascular events. Carotid intima-media thickness (CIMT) is a validated, non-invasive biomarker of early vascular alterations. Although the Mediterranean diet (MD) is well established as cardioprotective, its relationship with CIMT in young adults remains insufficiently studied. Objective: To assess sex-specific adherence to the Mediterranean diet and its association with carotid intima-media thickness in a cohort of university students. Methods: A cross-sectional study was performed involving 60 university students (50% male, aged 17–25 years), selected through stratified probabilistic sampling. Data were collected on sociodemographic characteristics, vascular risk factors, MD adherence via the PREDIMED questionnaire, and CIMT measured using a high-resolution carotid Doppler ultrasound. Statistical analyses included chi-square tests and descriptive statistics, with significance set at ρ ≤ 0.05. Results: A notable 95% of participants showed low adherence to the Mediterranean diet. Significant sex differences in dietary patterns were identified: males consumed more red meat (ρ = 0.023), while females reported higher fish intake (ρ = 0.037). Despite behavioral risk factors, all CIMT values remained within normal ranges (≤0.9 mm). No significant association was found between MD adherence and CIMT (ρ = 0.554). Conclusion: This exploratory study reveals a high prevalence of modifiable cardiovascular risk factors, including poor dietary adherence, among young adults, despite the absence of detectable vascular structural changes. Although no significant association was found, the findings reflect the dietary and behavioral profiles of a young, low-risk population.

Body image and mental health outcomes are influenced by both sex and body weight. This study investigated how sex and BMI category (participants classified with healthy weight, overweight, or with obesity) relate to body image, disordered eating, weight bias, global self-esteem and depression. Participants (N = 642; 278 (43.3%) males; 364 females (56,7%)) provided self-report measures of appearance satisfaction, body appreciation, overweight preoccupation, disordered eating scores, weight bias, depression, and self-esteem. The results indicated that women and participants classified with overweight and obesity based on BMI categories reported lower appearance satisfaction and body appreciation and a higher preoccupation with overweight and depression. Interaction effects showed that women participants with overweight and obesity reported particularly low appearance satisfaction and body appreciation. Individuals classified with healthy BMI category reported higher disordered eating scores than those classified with overweight. No significant effects were found for global self-esteem. These findings suggest that sex and BMI contribute to the study’s variables of interest, with some effects more pronounced in women with a higher BMI. The results align with sociocultural theories of appearance pressure but indicate complexity in disordered eating patterns. The findings underscore the importance of adopting intersectional, weight-inclusive, and sex-responsive approaches in both research and clinical practice.

Objective: The present study is a qualitative analysis of participant experiences and perspectives from people who received cognitive remediation therapy for adult obesity (CRT-O). Method: Post-intervention data were generated from an open-ended question requesting the participants to write, in the form of a letter to their therapist, about their experiences and reflections upon taking part in cognitive remediation therapy for adult obesity. Participants’ letters were thematically analyzed. Results: Four themes and nested subthemes emerged from participant responses, including (1) motivation and initial response to CRT-O for the adult obesity study eligibility process with the nested subthemes of initial apprehension pre-intervention and awareness and acknowledgement of one’s problematic eating behaviors; (2) perceived benefits from cognitive remediation therapy for adult obesity with the nested subthemes of the strategies and techniques that were found beneficial and the role of the cognitive remediation therapy for adult obesity therapists in facilitating positive change; (3) perceived outcomes post-intervention with the nested subthemes of changed relationship with food, self-acceptance and gaining control to effect positive lifestyle change; and (4) expectations and beliefs about the longer-term impact of cognitive remediation therapy for adult obesity with the nested subthemes of using the cognitive remediation therapy for adult obesity strategies as a lifestyle routine, apprehension about not having follow-up therapist support, and concern about potential relapse. Conclusion: Our analysis found helpful insights into the consumer perception of this novel intervention and highlighted the clinical utility of implementing cognitive remediation therapy in those living with a higher body weight.

Weight stigma remains a pervasive issue in contemporary society, impacting individuals’ psychological well-being, social inclusion, and access to opportunities. This study explored the lived experiences of overweight women, focusing on body image, stigma, and engagement with dominant health and beauty norms. Using a qualitative, phenomenological approach, online in-depth interviews were conducted with 14 women aged 25 to 51, primarily residing in southern and eastern Europe (Greece, Cyprus, Albania, Romania, and Bulgaria), with three participants from the United Kingdom. Thematic analysis revealed four key themes: workplace discrimination, pressures during pregnancy and the postpartum period, ambivalence toward body positivity movements, and the emotional toll of stigma, including extreme coping strategies. Participants described being marginalized professionally, scrutinized publicly and within families, and caught between ideals of inclusivity and persistent societal rejection. The findings emphasize the psychological burden of weight-based discrimination and the superficial nature of many body acceptance campaigns. This study calls for structural changes in healthcare, media, and employment practices to support body diversity and dismantle entrenched biases. By centering the voices of overweight women, the research contributes to broader discussions on embodiment, social justice, and intersectionality within the field of body image scholarship.