Remission Of Obesity Research Articles

Comprehensive visualization of bariatric surgery and gut microbiota research: a global analysis

BackgroundIn recent years, there has been a noteworthy increase in research exploring the relationship between gut microbiota and bariatric surgery. This increase can be attributed to the growing recognition of the importance of gut microbiota in diverse health issues, such as obesity, and its alterations following bariatric surgery. Consequently, this study seeks to employ bibliometric analysis to show the current research landscape and identify key areas of focus for future investigations on the link between bariatric surgery and gut microbiota.MethodsWe conducted a comprehensive search of the Scopus database to gather literature concerning bariatric surgery and its impact on the gut microbiota. The search encompassed documents published between 2009 and 2023. To analyze the bibliometric data, we employed diverse metrics, including publication count, citation count, and evaluation of the performance of countries, institutions, and journals. Additionally, we utilized VOSviewer to visually present the findings.ResultsA total of 555 articles focused on the correlation between bariatric surgery and the gut microbiota. Original research articles constituted 55.32% of all publications on this topic, followed by reviews at 37.30%. The leading countries in terms of publication volume were the USA (n = 156; 28.11%), China (n = 73; 13.15%), and the UK (n = 52; 9.37%). Co-occurrence analysis highlighted three main clusters of research topics: (1) the impact of bariatric surgery on the gut microbiota composition in relation to obesity remission, (2) the relationship between glucose metabolism, circulating bile acids, gut hormones, and gut microbiome remodeling, and (3) the connections between alterations in the gut microbiota and insulin resistance.ConclusionsOngoing research has investigated the connection between bariatric surgery and the gut microbiota, providing new perspectives on metabolic improvements after surgery. Further studies are necessary to comprehensively grasp how bariatric procedures influence the gut microbiota and to formulate precise interventions aimed at optimizing the health advantages of surgery.

Dynamics of childhood obesity in Hong Kong throughout the COVID-19 pandemic before and after the school closures: a 3-year longitudinal study

ObjectiveThis study is to evaluate if there is any difference in the balance between incidence of and remission from overweight/obesity in Hong Kong school-age children before and during the COVID-19 pandemic over three years. MethodsThis is a retrospective longitudinal study that involved children aged 6–16 years from a database of the School Physical Fitness Award Scheme. Results2765 students were longitudinally followed up for two years. The prevalence of childhood overweight/obesity was increased between the 2019 and 2021 academic years (P < 0.001). During the COVID-19 pandemic, the rate of obesity remission significantly reduced by 7.9 % (P = 0.003), at a background of a plateau of obesity among children and adolescents. ConclusionsOur study provides evidence on the impact of school closure and home confinement as a standard infection control measure for the prevention of COVID-19, which are likely to break the balance between incidence of and remission from childhood obesity.

Weight trajectories and obesity remission among school-aged children.

Many studies examining weight trajectories have used adiposity measures shown to be problematic for trajectory analysis in children with obesity, and remission of obesity remains poorly understood. To describe weight trajectories for school-aged children, the rate of obesity remission and factors associated. Children between 6 and 11 years of age with ≥3 valid height and weight measurements from an Oregon hospital-system over a minimum six-month period were included. Percent distance from the median body mass index (BMI) was used for modeling. Latent class analysis and linear mixed models were used to classify children based on their weight trajectory. We included 11,247 subjects with a median of 2.1 years of follow-up, with 1,614 (14.4%) classified as overweight and 1,794 (16.0%) classified as obese. Of subjects with obesity, 1% experienced remission during follow-up, whereas 23% of those with overweight moved to within a healthy weight range. Latent class analysis identified three classes within each weight-based stratum over time. The majority of children with overweight or obesity had a flat trajectory over time. Lower socioeconomic status was associated with a worsening trajectory. Latent class models using alternate measures (BMI, BMI z-scores, tri-ponderal mass index (TMI)) differed substantially from each other. Obesity remission was uncommon using the adiposity metric of distance from the median though transition from overweight to healthy weight was more common. Children with low socioeconomic status have worse trajectories overall. The choice of adiposity metric may have a substantial effect on the outcomes.

Clinical factors associated with remission of obese acanthosis nigricans after laparoscopic sleeve gastrectomy: a prospective cohort study.

Acanthosis nigricans (AN) involves skin hyperpigmentation in body folds and creases. Obesity-associated AN (OB_AN) is the most common type of AN. The skin condition of obese patients with AN can be improved through bariatric surgery, such as laparoscopic sleeve gastrectomy (LSG), after weight loss. However, the contributing factors to the remission of AN after surgery are still not fully determined. The authors aimed to assess the metabolic and pathological factors associated with remission of AN following LSG in obese individuals. The study included 319 obese patients who underwent LSG at our hospital. The subjects were divided into obesity (OB) only (OB, n =178) or OB with AN (OB_AN, n =141) groups. The basic clinical and metabolic indices and the dermatological features via reflectance confocal microscopy and histology were collected from patients prior to and after LSG. OB_AN patients had higher fasting plasma glucose, homeostatic model assessment for insulin resistance, and testosterone levels than OB patients. LSG could significantly improve the biochemical and histopathological features of OB_AN patients. The remissive rate of OB_AN patients was about 86.5% (122 out of 141) after surgery. The remission of OB_AN skin lesions was positively correlated with testosterone levels ( P <0.01). In addition, there was a significant positive correlation between changes in AN scores and epidermal thickness and skin pigmentation scores after surgery ( P <0.01). The remissive rate of OB_AN after LSG is associated with improved testosterone levels and reduced epidermal thickness and skin pigmentation levels.

Mechanisms of bariatric surgery for weight loss and diabetes remission.

Obesity and type 2 diabetes(T2D) lead to defects in intestinal hormones secretion, abnormalities in the composition of bile acids (BAs), increased systemic and adipose tissue inflammation, defects of branched-chain amino acids (BCAAs) catabolism, and dysbiosis of gut microbiota. Bariatric surgery (BS) has been shown to be highly effective in the treatment of obesity and T2D, which allows us to view BS not simply as weight-loss surgery but as a means of alleviating obesity and its comorbidities, especially T2D. In recent years, accumulating studies have focused on the mechanisms of BS to find out which metabolic parameters are affected by BS through which pathways, such as which hormones and inflammatory processes are altered. The literatures are saturated with the role of intestinal hormones and the gut-brain axis formed by their interaction with neural networks in the remission of obesity and T2D following BS. In addition, BAs, gut microbiota and other factors are also involved in these benefits after BS. The interaction of these factors makes the mechanisms of metabolic improvement induced by BS more complicated. To date, we do not fully understand the exact mechanisms of the metabolic alterations induced by BS and its impact on the disease process of T2D itself. This review summarizes the changes of intestinal hormones, BAs, BCAAs, gut microbiota, signaling proteins, growth differentiation factor 15, exosomes, adipose tissue, brain function, and food preferences after BS, so as to fully understand the actual working mechanisms of BS and provide nonsurgical therapeutic strategies for obesity and T2D.

Animal Protein Intake Is Associated with Obesity Remission After Roux-en-Y Gastric Bypass: an Isocaloric Replacement Analysis.

Some patients do not have the expected weight loss, and the post-surgical diet may partially explain these differences. To estimate the impact of macronutrient substitution on obesity remission after RYGB, considering the protein source. This study included 58 patients undergoing RYGB. Data collection was performed preoperatively, 3 and 12months after surgery.Eight participants dropped out of the study at 3 months,and the others remained for 12 months. The foods consumed were registered using a 24-h, 3-day food recall. For the isocaloric substitution analysis, foods were classified according to the protein source. The groups were compared using hypothesis tests, and Cox proportional hazard ratio regression was used to analyze isocaloric substitution. At three months after surgery, every 5% energy from plant protein replaced by animal protein increased by 3.50 [CI 1.204 - 10.205; p = 0.021] the probability of obesity remission. Stratified analysis by protein groups indicated that replacing vegetable protein with white meat was positively associated with remission of obesity. Every 5% vegetable protein replaced with white meat increased by 3.20 [CI 1.026 - 9.981; p = 0.045] the probability of obesity remission. Both results were independent of age, body mass index (BMI), and the presence of comorbidities. The results suggest that the consumption of animal proteins after RYGB, mainly white meat, favors weight loss.

Gut and obesity/metabolic disease: Focus on microbiota metabolites.

Obesity is often associated with the risk of chronic inflammation and other metabolic diseases, such as diabetes, cardiovascular disease, and cancer. The composition and activity of the gut microbiota play an important role in this process, affecting a range of physiological processes, such as nutrient absorption and energy metabolism. The active gut microbiota can produce a large number of physiologically active substances during the process of intestinal metabolism and reproduction, including short‐chain/long‐chain fatty acids, secondary bile acids, and tryptophan metabolites with beneficial effects on metabolism, as well as negative metabolites, including trimethylamine N‐oxide, delta‐valerobetaine, and imidazole propionate. How gut microbiota specifically affect and participate in metabolic and immune activities, especially the metabolites directly produced by gut microbiota, has attracted extensive attention. So far, some animal and human studies have shown that gut microbiota metabolites are correlated with host obesity, energy metabolism, and inflammation. Some pathways and mechanisms are slowly being discovered. Here, we will focus on the important metabolites of gut microbiota (beneficial and negative), and review their roles and mechanisms in obesity and related metabolic diseases, hoping to provide a new perspective for the treatment and remission of obesity and other metabolic diseases from the perspective of metabolites.

Altered Glucose Metabolism and Glucose Transporters in Systemic Organs After Bariatric Surgery.

The Roux-en-Y gastric bypass (RYGB) is highly effective in the remission of obesity and associated diabetes. The mechanisms underlying obesity and type 2 diabetes mellitus remission after RYGB remain unclear. This study aimed to evaluate the changes in continuous dynamic FDG uptake patterns after RYGB and examine the correlation between glucose metabolism and its transporters in variable endocrine organs using 18F-fluoro-2-deoxyglucose positron emission tomography images. Increased glucose metabolism in specific organs, such as the small intestine and various fat tissues, is closely associated with improved glycemic control after RYGB. In Otsuka Long-Evans Tokushima Fatty rats fed with high-fat diets, RYGB operation increases intestine glucose transporter expression and various fat tissues’ glucose transporters, which are not affected by insulin. The fasting glucose decrement was significantly associated with RYGB, sustained weight loss, post-RYGB oral glucose tolerance test (OGTT) area under the curve (AUC), glucose transporter, or glycolytic enzymes in the small bowel and various fat tissues. High intestinal glucose metabolism and white adipose tissue-dependent glucose metabolism correlated with metabolic benefit after RYGB. These findings suggest that the newly developed glucose biodistribution accompanied by increased glucose transporters is a mechanism associated with the systemic effect of RYGB.

Remission of obesity and insulin resistance is not sufficient to restore mitochondrial homeostasis in visceral adipose tissue

Metabolic plasticity is the ability of a biological system to adapt its metabolic phenotype to different environmental stressors. We used a whole-body and tissue-specific phenotypic, functional, proteomic, metabolomic and transcriptomic approach to systematically assess metabolic plasticity in diet-induced obese mice after a combined nutritional and exercise intervention. Although most obesity and overnutrition-related pathological features were successfully reverted, we observed a high degree of metabolic dysfunction in visceral white adipose tissue, characterized by abnormal mitochondrial morphology and functionality. Despite two sequential therapeutic interventions and an apparent global healthy phenotype, obesity triggered a cascade of events in visceral adipose tissue progressing from mitochondrial metabolic and proteostatic alterations to widespread cellular stress, which compromises its biosynthetic and recycling capacity. In humans, weight loss after bariatric surgery showed a transcriptional signature in visceral adipose tissue similar to our mouse model of obesity reversion. Overall, our data indicate that obesity prompts a lasting metabolic fingerprint that leads to a progressive breakdown of metabolic plasticity in visceral adipose tissue.

One anastomosis gastric bypass as a one-stage bariatric surgical procedure in patients with BMI ≥ 50 kg/m2

In patients with BMI ≥ 50 kg/m2, it is difficult to select an appropriate procedure that can lead to optimum results. This study aims to evaluate mid-term weight loss outcomes in patients with BMI ≥ 50 kg/m2 following one anastomosis gastric bypass (OAGB) as a one-stage procedure. A prospective study was conducted on patients with BMI ≥ 50 kg/m2, aged 18 years and above who had undergone primary OAGB from January 2016 to February 2019 with at least two years follow-ups. A total of 197 patients with BMI ≥ 50 kg/m2 had underwent OAGB. The mean age was 38 years and the mean pre-operative BMI was 53.7 kg/m2. Mean EWL% were 63.7%, 67.8% and 66.2% at one, two and five years after OAGB respectively. The highest level of EWL% was 68.4%, which was achieved in the 18th month following OAGB. OAGB can be performed safely in patients with BMI ≥ 50 kg/m2 as a one-stage procedure with acceptable weight loss outcomes and remission of obesity associated medical problems.

Impact of bariatric surgery in elderly patients with obesity.

to evaluate the long-term impact of bariatric surgery in the elderly population. a retrospective study including all patients older than 60 years who underwent Roux-en-Y gastric bypass (RYGB) at our center and maintained a follow-up longer than 1 year. Clinical and laboratory variables were studied to assess remission of obesity and its comorbidities, as well as variables directly related to the surgical procedure itself, including early and late complications. fifty-six patients were studied, mostly female (76,8%), with a mean age of 64.02 ± 3.34. A rate of complications of 37,5% was observed, with 10,7% requiring hospital admission and emergency surgery. The mean excess weight loss (%EWL) was 74.22% ± 26.76. The remission rates of hypertension and diabetes mellitus were 26.08% and 54.54%, respectively. There was significant difference in BMI reduction (12.25 ± 5.42, p<0.001), total cholesterol (31.37 ± 38.89 p<0,001), LDL cholesterol (23.45 ± 34.9, p=0.002), HDL cholesterol (5.14 ± 11.13, p=0,024), triglycerides (48.85 ± 56.15 p<0.001), HbA1C (1,81 ± 1,97, p<0,001) e PCR (1.43 ± 1.96, p<0.001). bariatric surgery was effective in weight loss and remission of comorbidities in the elderly obese population within the long term.

Long-Term Effects of Bariatric Surgery on Gut Microbiota Composition and Faecal Metabolome Related to Obesity Remission.

Obesity is one of the main worldwide public health concerns whose clinical management demands new therapeutic approaches. Bariatric surgery is the most efficient treatment when other therapies have previously failed. Due to the role of gut microbiota in obesity development, the knowledge of the link between bariatric surgery and gut microbiota could elucidate new mechanistic approaches. This study aims to evaluate the long-term effects of bariatric surgery in the faecal metagenome and metabolome of patients with severe obesity. Faecal and blood samples were collected before and four years after the intervention from patients with severe obesity. Biochemical, metagenomic and metabolomic analyses were performed and faecal short-chain fatty acids were measured. Bariatric surgery improved the obesity-related status of patients and significantly reshaped gut microbiota composition. Moreover, this procedure was associated with a specific metabolome profile characterized by a reduction in energetic and amino acid metabolism. Acetate, butyrate and propionate showed a significant reduction with bariatric surgery. Finally, correlation analysis suggested the existence of a long-term compositional and functional gut microbiota profile associated with the intervention. In conclusion, bariatric surgery triggered long-lasting effects on gut microbiota composition and faecal metabolome that could be associated with the remission of obesity.

Effects of vitamin D deficiency on the improvement of metabolic disorders in obese mice after vertical sleeve gastrectomy

Vertical sleeve gastrectomy (VSG) is one of the most commonly performed clinical bariatric surgeries for the remission of obesity and diabetes. Its effects include weight loss, improved insulin resistance, and the improvement of hepatic steatosis. Epidemiologic studies demonstrated that vitamin D deficiency (VDD) is associated with many diseases, including obesity. To explore the role of vitamin D in metabolic disorders for patients with obesity after VSG. We established a murine model of diet-induced obesity + VDD, and we performed VSGs to investigate VDD's effects on the improvement of metabolic disorders present in post-VSG obese mice. We observed that in HFD mice, the concentration of VitD3 is four fold of HFD + VDD one. In the post-VSG obese mice, VDD attenuated the improvements of hepatic steatosis, insulin resistance, intestinal inflammation and permeability, the maintenance of weight loss, the reduction of fat loss, and the restoration of intestinal flora that were weakened. Our results suggest that in post-VSG obese mice, maintaining a normal level of vitamin D plays an important role in maintaining the improvement of metabolic disorders.

Paediatric obesity treatment during 14 years in Sweden: Lessons from the Swedish Childhood Obesity Treatment Register-BORIS.

Treatment of paediatric obesity has been offered customarily and free of charge for more than 15 years in Sweden. The Swedish Childhood Obesity Treatment Register (BORIS) is a prospective register of children and adolescents undergoing obesity treatment. To investigate how patient characteristics and treatment efficacy has changed over 14 years on a national scale. All subjects in BORIS with data from 2004 until 2017 were included, n = 21 499. Outcomes were age and BMI SDS at treatment initiation, dropout rates and treatment outcome up to 3 years after treatment initiation. Age and BMI SDS at treatment initiation have decreased during the years (both P < .0001). Of the patients who started treatment before 2009, more than 80% had at least 1-year follow-up. This number has decreased to about 60% in 2017. Since 2004, no trend in improvement of treatment results was observed when evaluating change in either BMI SDS or proportion of obesity remission. There was no difference between the sexes. Although children in Sweden receive treatment at an earlier age, which is a major determinant of treatment success, and at a lower degree of obesity at treatment initiation, the effect of childhood obesity treatment on standard anthropometric measures has not improved over the investigated years.

Association of Changes in Physical Activity and Incidence and Remission of Overall and Abdominal Obesity in 113,950 Adults.

This study examined the dose-response relationship between changes in physical activity (PA) and subsequent incidence or remission of overall and abdominal obesity. A total of 113,950 healthy individuals aged ≥ 18 years participating in the Taiwan MJ Cohort were included. Two-year changes in PA between the first and second examination were linked to subsequent development and remission of overall and abdominal obesity. During a mean 5.6-year follow-up after the second examination, 9,991 and 11,488 individuals developed overall and abdominal obesity, respectively; also, 3,588 and 3,156 participants with obesity lost sufficient weight or reduced their waist circumference to be classified as nonobese. Compared with no changes in PA, the multivariable hazard ratio (95% CI) of overall obesity was 0.95 (0.90-1.00) for a PA increase of 0.01 to 3.74 metabolic equivalent hours (MET-h)perweek and 0.86 (0.80-0.91) for a PA increase of ≥ 3.75 MET-hperweek. Corresponding values for remission of obesity were 1.00 (0.91-1.09) and 1.16 (1.05-1.28). Similar results were observed for the development and remission of abdominal obesity. Any decrease in PA was not associated with the risk of obesity outcomes when compared with a stable pattern (0 MET-h/week). Increasing PA was consistently associated with a progressively lower incidence and higher remission of overall and abdominal obesity.

Metabolic Impact of Body Fat Percentage Independent of Body Mass Index in Women with Obesity Remission After Gastric Bypass

Background/ObjectiveBody mass index (BMI) is central when evaluating treatment effect after gastric bypass. The metabolic impact of BMI-independent differences in body fat percentage (BF%) after gastric bypass is not fully understood. We compared metabolic and adipose tissue characteristics in women with high versus low BF% independent of BMI after obesity remission following gastric bypass.Subjects/MethodsA cohort of 215 women was included at baseline. A total of 166 women were re-examined 2 years after gastric bypass, whereof 130 had obesity remission (BMI < 30 kg/m2). Anthropometric parameters, blood pressure, and lipids were measured. Total and regional body fat mass was determined by dual-energy X-ray absorptiometry. Insulin sensitivity was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and hyperinsulinemic euglycemic clamp (M value). Adipocyte size and number were determined.ResultsOf the 130 women with obesity remission, 64 had BF% ≥ 35 and 65 < 35. Independent of BMI, high BF% were associated with higher HOMA-IR (P = 0.021), lower M value (P = 0.0046), higher triglycerides (P = 0.013), higher visceral/total and android/gynoid fat mass ratios (P = 0.0032 and 0.0003 respectively), and larger subcutaneous fat cell volume (P < 0.0001) 2 years after gastric bypass. No differences in anthropometric measures, glucose, blood pressure, or fat cell number were observed.ConclusionsIndependent of BMI, patients with higher BF% displayed lower insulin sensitivity, higher triglyceride levels, central fat distribution, and larger subcutaneous adipocytes 2 years after gastric bypass. Thus, determination of BF% provides additional information of metabolic characteristics at follow-up of non-obese patients after gastric bypass.

Increase in Protein Intake After 3Months of RYGB Is an Independent Predictor for the Remission of Obesity in the First Year of Surgery.

Although bariatric surgery promotes dietary changes, many questions regarding their effect on weight loss remain unanswered. The aim of this study was to evaluate changes in dietary intake and predictive factors of obesity remission in the first 12months after RYGB. Fifty-one patients (mean 39.34 ± 9.38years, 68.7% women) who underwent RYGB were included in this study. Dietary intake was evaluated through a 24-h dietary recall and subsequently classified by NOVA, macronutrients and calories. The predictive factors for obesity remission within 12months after RYGB were evaluated by Cox regression. At baseline, 62.7% of the patients presented severe obesity; mean excess weight loss was greater than 80% after 1year of surgery and about 70% of the patients were no longer diagnosed with obesity. An increase in percentage of calories from protein was observed at 3 and 12months after surgery. The caloric contribution of ultra-processed foods was low at 3months after surgery while that of unprocessed or minimally processed foods was high at 3 and 12months after surgery. From the Cox regression analysis, preoperative BMI (HR, 0.78; 95% CI, 0.69-0.88) and age (HR, 0.94; 95% CI, 0.89-0.99) showed an inverse association with obesity remission. Also, Δ protein (at 3months-baseline) showed a positive association with obesity remission (HR, 1.06; 95% CI, 1.01-1.12). Lower preoperative BMI, lower age, and higher protein intake at 3months after surgery may favor remission of obesity in up to 12months compared with baseline.

Pu-erh Tea Regulates Fatty Acid Metabolism in Mice Under High-Fat Diet.

Pu-erh tea has been extensively reported to possess lipid lowering effects but the underlying mechanisms remained unclear. Free fatty acids (FFAs) are generally correlated with the development of obesity, leading to increased risk for type 2 diabetes mellitus and cardiovascular diseases. To investigate whether Pu-erh tea treatment alters FA metabolism, we treated HFD induced obese mice with Pu-erh tea for 22 weeks and analyzed FFA profiles of experimental mice using a UPLC-QTOF-MS platform. Results showed remarkable changes in metabolic phenotypes and FFA compositions in mice treated with or without Pu-erh tea. HFD induced a marked obese phenotype in mice as revealed by significantly increased body weight, liver and adipose tissue weight, lipid levels in serum and liver, and these parameters were markedly reduced by Pu-erh tea treatment. Several FFA or FFA ratios, such as DGLA, palmitoleic acid, and OA/SA ratio, were significantly increased while the levels of SA/PA and AA/DGLA were significantly reduced in HFD-induced obese mice. Interestingly, these differential FFAs or FFA ratios were previous identified as key markers in human obese subjects, and their changes observed in the HFD group were reversed by Pu-erh tea treatment. Moreover, a panel of FFA markers including C20:3 n6/C18:3 n6 and C20:3 n6/C20:2 n6, C18:3 n6/C18:2 n6, C18:3 n3/C18:2 n6 and C24:1 n9/C22:1 n9, which were previously identified as biomarkers in predicting the remission of obesity and diabetes in human subjects who underwent metabolic surgery procedures, were reversed by Pu-erh tea intervention. Pu-erh tea significantly improved glucose homeostasis and insulin tolerance compared to the HFD group. Additionally, Pu-erh tea treatment significantly decreased FFA synthesis genes and increased the expression of genes involved in FFA uptake and β-oxidation including FATP2, FATP5, PPARα, CPT1α, and ACOX-1. These finding confirmed the beneficial effects of Pu-erh tea on regulating lipid and glucose metabolism, and further validated a panel of FFA markers with diagnostic and prognostic value for obesity and diabetes.

Remission of obesity among a nationally representative sample of US children

Little is known about the incidence and natural history of obesity remission among children outside of weight loss programmes. The objectives are to characterize and identify sociodemographic and early life predictors of obesity remission between kindergarten and eighth grade among a nationally representative sample of US children. The sample included children with obesity [age-specific and gender-specific body mass index percentile (BMI) ≥95] at the spring kindergarten assessment of the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99. Weight categories across 8years of follow-up were used to identify three transition patterns: persistent obesity remission, non-persistent obesity remission and non-remission. Weight, height and BMI changes between remission categories were examined and predictors of persistent remission were identified. One-third of children with obesity in kindergarten experienced remission during follow-up and 21.6% of children experienced persistent remission through eighth grade. Female gender and high socio-economic status predicted persistent remission; these associations were attenuated after accounting for baseline BMI. Children experiencing persistent remission gained less weight across waves than those experiencing non-remission. A meaningful proportion of young children with obesity experience remission by eighth grade. Further study is needed to identify factors that support obesity remission among children outside of treatment contexts.

Weight Mobility and Obesity in a Representative Sample of the US Adult Population.

Background Despite the attention given to the prevalence of obesity, surprisingly little is known about the incidence or reduction of obesity. We report the 1-year incidence and remission of obesity in a representative sample of the US population. Methods Individuals from the Medical Expenditure Panel Survey (MEPS) panel 17 were classified into standard obesity categories at enrollment and one year later. Incidence rates were calculated by age. Results Although the overall prevalence of obesity remained nearly constant, remission rates from obesity (stratified by age) ranged from 11 to 27% while incidence rates ranged from 6 to 16%. For almost all age levels, the proportion of individuals leaving an obese or overweight state was greater than or equal to the proportion who progressed to a more severe level of overweight or obesity. Overall, 36% of adults lost at least 2.5 kg/m2 in the one-year period; only 8% gained 2.5 kg/m2 or more. Individuals less than 25 years of age had higher rates of leaving overweight (23% versus <16%) and obesity (27% versus 24%) classifications than people of other ages. Conclusions Prevalence rates of obesity are well documented in the United States, but incidence is understudied. Public health efforts that target young people with overweight or obesity may yield the greatest benefit.