Overweight and obesity among physicians are increasingly recognized as relevant to workforce health, quality of care, and the credibility of lifestyle counseling delivered to patients. Physicians may face constraints that affect dietary patterns, physical activity, and daily routine, behaviors directly related to BMI. However, data linking specific lifestyle behaviors to BMI in this population remain limited. To examine associations between self-reported health behaviors and BMI among physicians and outline implications for workplace wellness. Cross-sectional online survey of physicians using the 26-item Healthy Lifestyle and Personal Control Questionnaire (HLPCQ). Participants were categorized into normal weight (BMI < 25) and overweight or obesity (BMI ≥ 25) groups based on their BMI. Group differences and multivariable logistic regression were applied. Of 200 respondents, 144 complete cases were analyzed; 54.2% had a BMI < 25. Higher BMI was associated with lower adherence to health-promoting behaviors, notably Dietary Harm Avoidance (p<0.01), Daily Routine (p=0.05), and Organized Physical Exercise (p=0.03). Regression analysis identified Dietary Harm Avoidance and Organized Physical Exercise as protective factors against overweight and obesity (p<0.01). Physicians in surgical specialties reported lower health behavior scores than non-surgical peers, particularly in Daily Routine (p<0.01) and in total lifestyle scores (p=0.01). Specific lifestyle behaviors, particularly dietary harm avoidance and organized physical activity, were associated with BMI among physicians. These associations may help inform future research on modifiable behavioral factors related to overweight and obesity among physicians.

ABSTRACT Background Postpartum weight retention is a key concern due to the risk of escalating overweight/obesity, as well as the risk of diabetes, hypertension, and cardiovascular disease. Self‐weighing may be a helpful strategy for reducing weight retention; however, the ideal frequency of self‐weighing is not known. Methods The objective of this secondary analysis ( N = 263) examined the role of self‐weighing during the 6‐month postpartum period, with a focus on substantial postpartum weight retention (i.e., ≥ 5 kg). All participants received e‐scales at randomization, which captured daily self‐weighing data over the postpartum period (6 weeks postpartum to 6 months postpartum). Multivariable logistic and linear regression models were applied to determine the association between self‐weighing frequency and postpartum weight retention while controlling for covariates. Results Most participants had overweight or obesity (68.7%), were nulliparous (47.5%), and identified as White (67.3%). The mean self‐weighing frequency was 2.45 ± 1.86 days per week. Each additional day of self‐weighing per week was associated with 34% lower odds of substantial postpartum weight retention, relative to &lt; 0.5 kg weight retention (OR: 0.66, 95th CI: 0.54,0.84, p = 0.001). Self‐weighing ≥ 4 days per week was associated with 3.3 kg lower weight retention, compared to participants who weighed less frequently ( β = −2.89, 95th CI: −4.51,−1.27, p = 0.001). Conclusions Thus, self‐weighing ≥ 4 days per week could be tested as a goal for postpartum weight management. These findings may inform future postpartum weight management programs, as self‐weighing is an easily disseminated strategy. Trial Registration The trial is registered on clinicaltrials.gov (NCT 03057808)

ABSTRACTObjectiveObesity and overweight are associated with significant psychosocial burden. Existing patient‐reported outcome (PRO) measures only assess a subset of emotion‐related concepts that are relevant to individuals living with these conditions. The Weight and Emotions Scale (WES) was developed to enable robust evaluation of the impact of obesity or overweight and the benefits of treatment on patients' emotional functioning.MethodsThe WES was developed based on findings from interviews with participants (N = 40) exiting a Phase 2 trial for retatrutide (NCT04881760), a targeted literature review, and interviews with clinicians specialized in obesity medicine (N = 3). Cognitive interviews were conducted with adults with obesity/overweight and ≥ 1 obesity‐related complication (N = 20) to evaluate the WES content.ResultsAll cognitive interview participants expressed a positive overall impression of the WES, reported that they understood the instructions, response options, and recall period, and that the questions were easy to answer. Most items (75%) were understood by all the participants and were rated as “very important” or “moderately important” by ≥ 75% of the participants. The WES is a new 16‐item PRO measure evaluating 13 emotion‐related concepts.ConclusionsThe WES may be used in clinical trials, observational research, or clinical practice to robustly assess the impact of obesity or overweight and the benefits of treatment on patients' emotional functioning.

ABSTRACTBackgroundIn perioperative settings exercise testing can be used to assess a patient's physical fitness, with VO2max used as a marker to indicate fitness and subsequent risk of adverse surgical outcomes. However, the commonly used reporting methods of VO2max may be problematic in populations with excessive FM such as those awaiting MBS for obesity. Hence, alternative ways of expressing VO2max will be explored.MethodsHistorical data from individuals presenting for MBS were analyzed. Predicted VO2max values were adjusted relative to the participants measured and “normative” body mass, where each prediction was assigned a classification score. Predicted VO2max adjusted to the participants measured FFM was also considered. Data were compared to individuals that are lean and sedentary as well as those with obesity from a previous study.ResultsData from 20 participants awaiting MBS (43.15 ± 11.82 years, 68.50 ± 8.39 cm, 115.29 ± 16.82 kg and 59.93 ± 8.69 kg FFM) were examined. Predicted VO2max relative: to total mass was 20.15 ± 5.00 mL/kg/min; normative body mass was 30.04 ± 6.58 mL/kg/min; and FFM was 38.55 ± 9.08 mL/kg FFM/min. Median fitness classifications increased from very poor to poor when predicted VO2max was expressed relative to normative body mass.ConclusionsReporting predicted VO2max results relative to body mass may be underestimating fitness and overestimating surgical risk in people who are very obese.

ABSTRACTAimsObesity‐related complications (ORCs) are associated with substantial health and economic burdens. Although treatment targets are routinely used for other chronic conditions, none currently exist in obesity management. We aimed to identify an adiposity measure that indicates a reduced risk of four ORCs.Materials and MethodsThis population‐based cohort study of patients aged 18–60 years used data from the UK Clinical Practice Research Datalink Aurum. Associations between absolute 10‐year ORC risk and baseline body mass index (BMI), waist–height ratio (WHtR), and changes in adiposity measures after weight loss were calculated. Absolute values and changes in adiposity measures were evaluated as a proxy for achieving an absolute 10‐year ORC risk similar to that of people without obesity, and optimal cut‐offs were identified based on the balance between true positive and true negative rates for achieving the treatment goal.ResultsAbsolute values of BMI and WHtR post‐weight change were more strongly associated with 10‐year ORC risk than relative changes; WHtR was the best proxy for a low absolute risk for type 2 diabetes, hypertension, and atherosclerotic cardiovascular disease, and BMI for hip/knee osteoarthritis. Based on the balance between true negative and true positive rates of multiple cut‐offs, a BMI ≤ 27 kg/m2 and WHtR ≤ 0.53 are proposed as potential treatment targets for obesity.ConclusionsThese findings suggest that treatment goals for obesity management may be considered on post–weight‐change absolute adiposity measures, rather than relative changes. Both weight and WHtR may be considered when defining treatment targets for ORC risk reduction.

ABSTRACTObjectiveWeight management during the first few years postpartum is considered important for the prevention of future metabolic disturbances. Body fat percentage measured using air displacement plethysmography is an accurate marker of body adiposity. In this secondary analysis of a randomized controlled trial, the aims were to identify distinctive body fat percentage trajectories up to 2 years postpartum in women with overweight and to investigate whether fish oil and/or probiotic supplements, diet, gestational diabetes, or gestational weight gain influenced the body composition.MethodsWomen with overweight or obesity (n = 439) were randomized to receive fish oil (1.9 g docosahexaenoic acid and 0.22 g eicosapentaenoic acid) and/or probiotics (Lacticaseibacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 CFU each) in a double‐blind manner from early pregnancy until 6 months postpartum. Body composition (n = 329) was measured using air displacement plethysmography, at three, six, 12, and 24 months postpartum. Diet in early pregnancy was evaluated using nutrient intakes, dietary patterns, and the Index of Diet Quality (IDQ) questionnaire.ResultsThree postpartum body fat percentage trajectories were identified, but none displayed a sustained decrease in adiposity. A healthy dietary pattern (adjusted OR 5.8 [95% CI 2.5–13.5], p < 0.001) and high IDQ score (adjusted OR 2.5 [95% CI 1.1–5.5], p = 0.023) in early pregnancy increased the odds of a decreasing trend during the first postpartum year. The fish oil and/or probiotic intervention did not impact the body composition.ConclusionGood overall dietary quality during pregnancy may benefit the body composition of women with overweight or obesity at postpartum.Trial RegistrationNCT01922791, ClinicalTrials.gov

ABSTRACTBackgroundMetabolic and bariatric surgery (MBS) is the most effective and durable approach to treating obesity, yet recurrent weight gain occurs in a subset of patients. Primary care often serves as a routine point of contact for patients following MBS and is a potential gateway for addressing and/or preventing recurrent weight gain.MethodsAlthough guidelines for the management of recurrent weight gain after MBS exist, this narrative review was undertaken to clarify the role of the primary care providers in enhancing long‐term outcomes and preventing weight gain after MBS.FindingsRegular follow‐up in primary care provides an opportunity to identify challenges related to weight management and overall health outcomes, which may include concerns related to nutrition, mental or physical well‐being, body image, motivation, and behavior change, for example. The availability of multidisciplinary providers within primary care settings, including behavioral health specialists, dietitians, and physical therapists, is an important strength of this setting in addressing potential post‐MBS concerns such as recurrent weight gain.ConclusionThis review outlines clinical considerations for managing recurrent weight gain post‐MBS in primary care and includes recommendations for both primary care providers and specialty clinicians working in primary care to deliver care effectively and mitigate weight stigma post‐MBS.

ABSTRACTBackgroundExperiencing bias and stigma are social determinants of health (SDoH). Recently, internalized weight bias (IWB) has been included as an SDoH in obesity medicine. This study examined the association of IWB with other pillars of SDoH and how IWB contributes to cumulative social disadvantage for people living with obesity.MethodsA cross‐sectional, web‐based survey was conducted in the United States (May–December 2022) with a sample of adults with obesity or overweight. Multiple linear regression was performed to evaluate the relationship between WSSQ (higher score indicating experiencing more IWB) and other pillars of SDoH.ResultsParticipants who reported race as Black (adjusted mean difference [95% CI] −3.86 [−5.21, −2.52]; p < 0.001) or multiracial (−3.26 [−5.37, −1.16]; p = 0.002) had significantly lower total WSSQ scores than those who self‐identified as White race. Participants who experienced negative social interactions due to weight had significantly higher total WSSQ scores (7.04 [5.81, 8.27]; p < 0.001) than those who did not.ConclusionThe study showed that IWB is associated with certain other pillars of SDoH. Findings highlight the need for a comprehensive and patient‐centric approach to managing individuals with greater IWB, which may contribute to a higher cumulative social disadvantage and, consequently, worse health outcomes.

Weight-based victimization represents a critical challenge for youth, particularly those with obesity, and has been linked to a range of negative psychological, academic, and behavioral outcomes. While research has extensively examined in-person victimization, the rise of digital platforms has given way to weight-based cybervictimization, which remains understudied. This paper highlights the urgent need for research, prevention, and intervention strategies focused on weight-based cybervictimization, emphasizing its harmful effects and its overlap with traditional forms of victimization. It identifies gaps in the existing literature, particularly regarding the inconsistent use of assessment tools and terminology in research on weight-based victimization, and proposes the necessity for culturally relevant and validated measurement tools that accurately capture youth experiences. Finally, it aims to inform best practices for healthcare providers, educators, and parents by promoting strategies that effectively address and mitigate the impact of weight-based victimization among youth.

Mechanisms by which glucagon-like peptide receptor agonists (GLPRAs) improve cardiovascular outcomes remain incompletely understood. Whether taking GLPRAs are associated with differential dietary patterns remains unknown. Data from the National Health and Nutrition Examination Survey (2009-2020) were used to match GLPRA users to non-users with exact matching. Dietary patterns were identified using principal component analysis. The four dietary patterns were "Standard American", "Legume-Heavy", "Animal Protein and Vegetable", and "Whole Food Carbohydrate". In a multinomial logit model among matched cases (n=127) and comparisons (n=1264), taking a GLPRA (vs. not) was associated with lower alignment with the Legume-Heavy pattern (0.15 vs. 0.24, p=0.01), but no difference for Standard American (0.29 vs. 0.29, p=0.97), Animal Protein and Vegetable (0.30 vs. 0.22, p=0.07), or Whole Food Carbohydrate patterns (0.26 vs. 0.25, p=0.87). There was no difference in dietary quality based on taking or not taking GLPRAs (mean Healthy Eating Index 53.7 (12.1) versus 52.6 (12.3), p=0.09). GLPRAs were associated with lower likelihood of legume-focused dietary pattern and no difference in dietary healthfulness. Without simultaneous improvement in dietary healthfulness, there is a risk of a missed opportunity to promote healthy dietary habits among those taking GLPRAs.