Obesity Care Tag

New Research Shows Obesity May Reshape How Breast Cancer Spreads

Key Takeaways:

• Obesity may alter how early, non-invasive breast lesions progress into invasive cancer, a University of Oklahoma study suggests.
  
• In women with obesity, progression was linked to inflammation, immune cell activity, metabolic changes and raised levels of the enzyme SULF2 – not the rapid cell division seen in women without obesity.
  
• The findings could improve risk prediction for women with DCIS and help reduce overtreatment.
  
  
  

A different route to invasive disease

Obesity may change how early-stage breast cancer becomes invasive, according to a study by University of Oklahoma researchers published in The American Journal of Pathology.

Obesity is already recognised as a risk factor for invasive breast cancer, but researchers have not fully understood how it helps early, non-invasive breast lesions develop into invasive cancer. A clearer picture of this process could strengthen physicians’ ability to predict and treat the disease.

In the study, breast cancers in women without obesity displayed the typical signs of turning invasive, including rapid cell division and an increased ability to invade neighbouring tissue. In women with obesity, however, the researchers identified a different set of biological changes that appeared to help the cancer become invasive.

The cancer environment became more inflamed, with the arrival of immune cells that advanced the growth of the tumour. The tumour cells also appeared better able to survive under stress, and there were changes in cellular metabolism – how the cells use nutrients for energy.

“This could be why women with obesity are at higher risk for invasive breast cancer,” said Bethany Hannafon, Ph.D., co-lead author of the study and an assistant professor in the Department of Obstetrics and Gynecology at the OU College of Medicine. “The changes that the cancer cells are undergoing are allowing them to survive and thrive.”

A cooperative cancer “neighbourhood”

The researchers also found differences in the “neighbourhood” of cells and tissues surrounding the cancer. Epithelial cells, where the tumour originally develops, co-opt other cells around them to create an environment that is even more conducive to cancer growth.

“In women with obesity, there is cooperation between all the cell types, not just the cancer cells, which helps an early pre-cancer to become an invasive breast cancer,” said co-lead author Elizabeth Wellberg, Ph.D., assistant professor in the Department of Pathology at the OU College of Medicine. “That may be an area of future study – can a drug or intervention that targets only one cell type interrupt the whole network of progression toward invasive cancer?”

The role of the enzyme SULF2

The research team additionally discovered higher levels of an enzyme called Sulfatase 2 (SULF2) in the tumour cells of women with obesity, suggesting that it may play an important part in cancer progression. SULF2 will be a further focus of future studies.

Why better DCIS risk prediction matters

Understanding what causes early, non-invasive tumours – known as ductal carcinoma in situ, or DCIS – to become invasive is important because not all women will go on to develop invasive cancer, yet they currently receive the same treatment.

“In women diagnosed with DCIS, about half will later develop invasive ductal carcinoma (IDC) that spreads into surrounding breast tissue. But we currently have no way of determining which women are most at risk. As a result, many women with DCIS receive the same treatments used for IDC, including surgery, radiation and sometimes hormone therapy. Overtreatment is a major concern, but if we had better ways of determining risk, unnecessary treatments could potentially be reduced,” Hannafon said.

While breast cancer survival rates have improved over the past two decades, the number of women diagnosed with invasive breast cancer has not declined – underscoring the need for better ways to predict and prevent disease progression.

A growing public health concern

The rising prevalence of obesity gives the findings added weight.

“Obesity is on the rise – 50% of Americans are expected to be obese by 2030,” said the paper’s first author, Cole Hladik, Ph.D., who worked in Hannafon’s lab while earning his doctorate. “That statistic further highlights the importance of considering a patient’s metabolic health alongside the biology of the tumor itself.”

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Semaglutide Shows Benefit in Severe, Long-Standing Treatment-Resistant Obesity, Trial Finds

Key Takeaways:

• Weekly semaglutide (2.4 mg) cut BMI by an average of 19 per cent – around 22.3 kg – over 68 weeks in young adults with treatment-resistant severe obesity.
  
• Benefits went beyond weight, with large falls in total, abdominal and liver fat and in metabolic syndrome severity, lowering cardiovascular and type 2 diabetes risk.
  
• The drug was safe and well tolerated, with only mild, short-lived side effects and no related dropouts.
  
  
  

A promising option for hard-to-treat obesity

A weekly dose of semaglutide (2.4 mg) leads to a clinically significant reduction in body mass index (BMI) and related health outcomes in young adults living with severe obesity who are resistant to treatment following hospital-based, non-pharmacological obesity care during childhood. That is the finding of a randomised controlled trial being presented at this year’s European Congress on Obesity (ECO).

The study, led by researchers from the University of Copenhagen and Holbæk Hospital in Denmark, highlights the importance of identifying as early as possible the children who are resistant to hospital-based obesity care and who may benefit from the timely addition of semaglutide or other glucagon-like peptide-1 receptor agonists (GLP-1 RAs).

Semaglutide and other GLP-1 RAs work by mimicking naturally produced incretin hormones. These hormones help to lower blood sugar levels after a meal and reduce appetite, prompting people to eat less.

Why new strategies are urgently needed

Children living with obesity are five times as likely to be living with obesity in adulthood as their healthy-weight counterparts [1]. Obesity that begins in early childhood carries significant health risks in early adulthood, including early-onset type 2 diabetes, cancer, cardiovascular disease and a reduced quality of life.

Hospital-based, non-pharmacological obesity care – which involves supporting children living with obesity and their families to improve health and thriving during growth and development – has been shown to reduce childhood obesity. However, around one in four children are more difficult to treat, and any reduction in the degree of obesity is hard to maintain. New, effective and safe treatment strategies are therefore urgently needed.

Inside the RESETTLE trial

In the new RESETTLE trial – a randomised, placebo-controlled, double-blind study – the researchers investigated the effect of semaglutide treatment in young adults (aged 18 to 28 years) who were still living with severe obesity despite at least one year of treatment at the Children’s Obesity Clinic, European Centre for Obesity Management, at Holbæk Hospital in Denmark.

The study involved 246 young adults (average age 23 years, 59 per cent female) who had been included in the HOLBAEK Study [2]. Participants were randomised into four different groups, based on how they had previously responded to the paediatric hospital-based treatment programme and on their current BMI:

• 82 participants with a low response to childhood obesity care (a change in BMI that was not enough to improve their health) and who were currently living with obesity as young adults (BMI of 30 kg/m² or above).
  
• 80 participants with a medium response to childhood obesity care and living with obesity as young adults (BMI of 30 kg/m² or above).
  
• 34 participants with a high response to childhood obesity care who were not living with obesity as young adults (BMI below 30 kg/m²).
  
• 50 participants from a population-based reference group who had a normal weight development in childhood.
  
  
  

What the assessments measured

All participants, regardless of their response group, underwent examinations of cardiometabolic biomarkers (waist circumference; lipids in the blood, including cholesterol; blood glucose; and blood pressure), full-body dual-energy x-ray absorptiometry (DXA) imaging of body composition, and magnetic resonance imaging (MRI) of liver and visceral (abdominal) fat.

The 162 participants in the low- and medium-response groups – who had poorer health outcomes than the high-response and normal-BMI-development groups – were randomly assigned to either weekly injections of semaglutide (2.4 mg; 54 in the low-response group and 55 in the medium-response group) or placebo (28 and 25 respectively) over 68 weeks. In total, 152 participants (94 per cent) attended the final visit.

Results: large reductions in BMI and weight

After 68 weeks, semaglutide led to an average decrease in BMI of 19 per cent (average weight loss of 22.3 kg) in both the low- and medium-response groups, compared with placebo.

In the low-response group, average BMI among those taking semaglutide fell by 7.3 kg/m² (from 40.5 kg/m²), compared with a minor increase of 0.5 kg/m² in the placebo group. Similarly, in the medium-response group, average BMI decreased by 6.7 kg/m² (from 38.0 kg/m²) among those taking semaglutide, but rose by 0.6 kg/m² among those given placebo (see figure 1 in the full abstract).

Beyond weight: fat and metabolic health

Participants in the low- and medium-response groups who received semaglutide also saw substantial improvements in total fat mass (-17 kg and -15 kg respectively), abdominal fat (-48 per cent and -41 per cent) and liver fat (-39 per cent and -34 per cent) compared with placebo – all key factors in reducing obesity-related health risks.

In addition, these participants experienced substantial improvements in their metabolic syndrome severity score (-0.80 and -0.58), a measure that integrates lipids, blood pressure, fasting glucose and waist circumference into a single value. This reflects a substantial reduction in the risk of developing cardiovascular disease and type 2 diabetes.

Safety and tolerability

Semaglutide was safe and generally well tolerated. Gastrointestinal side effects, such as nausea and abdominal pain, were the most common. However, most side effects were manageable, resolved over time, and did not lead to participants dropping out of the trial.

What the researchers say

“By reducing the degree of obesity and improving cardiometabolic health irrespective of prior response to childhood obesity care, GLP-1 based treatment could help more young people with severe obesity to reduce their burden of obesity-related complications in early adulthood,” said author Joachim Holt from the University of Copenhagen.

According to study lead Professor Signe Sørensen Torekov at the University of Copenhagen, “Severe obesity in young people is a complex, chronic disease with serious health consequences. GLP-1 based treatment offers a promising option for managing severe obesity in young people who are resistant to prior hospital-based non-pharmacological care. Importantly, supporting families to implement increased physical activity and health behaviours should remain the foundation of all treatments for childhood obesity and prevention of obesity across generations.”

Head consultant Jens-Christian Holm, of the Children’s Obesity Clinic, European Centre for Obesity Management, Holbæk University Hospital, adds that, “Childhood obesity is a chronic disease resulting in numerous complications reducing physical, mental and social thriving during growth and development. Being able to optimise obesity treatment with the addition of drugs in selected patients to improve health is a worldwide imperative.”

CCH insights:

Once again, GLP-1 therapy delivers excellent results, providing the necessary change in appetite that allowed these young people to make the behavioural changes needed to lose weight and improve health, when previously they had been unable to do so. And it is not just about losing weight, with significant improvements in metabolic and cardiovascular disease risk factors.

References:

[1] Predicting adult obesity from childhood obesity: a systematic review and meta‐analysis – Simmonds – 2016 – Obesity Reviews – Wiley Online Library

[2] The HOLBAEK Study includes more than 4,000 Danish children and adolescents with and without obesity (Study Details | NCT02852694 | Reduce Risk for Crohn’s Disease Patients | ClinicalTrials.gov).

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Four Weeks of Tomato-Soy Juice Lowered Inflammation in Adults with Obesity

Key Takeaways:

• In a four-week study, a tomato-soy juice rich in lycopene and soy isoflavones significantly reduced three blood markers of systemic inflammation in healthy adults with obesity, while a control tomato juice lacking those compounds did not.
  
• The researchers chose a low-carotenoid tomato juice as the comparison drink, rather than water, so they could isolate the effects of the lycopene and isoflavones rather than the effects of tomato juice in general.
  
• Building on these results and supporting animal data, the team has secured federal funding for a pilot clinical trial examining whether the same juice can ease inflammation in people living with pancreatitis.
  
  
  

A food-based approach to inflammation

Drinking a tomato-soy juice packed with plant compounds previously shown in animal studies to support health lowered pro-inflammatory proteins in healthy adults with obesity after four weeks, according to a new study. The researchers say the findings point to the juice’s potential as a functional food that could help rein in the persistent, unchecked inflammation that underpins a wide range of chronic conditions.

The juice was formulated to deliver high levels of two plant-based compounds, lycopene and soy isoflavones, both of which earlier research suggests have antioxidant and anti-inflammatory properties. Measured against a control tomato juice that lacked these compounds, the tomato-soy juice produced a significant drop in the blood levels of three proteins that serve as markers of systemic inflammation.

“The idea is, can we use food-based interventions to modulate inflammation?” said lead author Jessica Cooperstone, associate professor of horticulture and crop science at The Ohio State University. “And can we test this in a rigorous way so that we can really see this is affecting inflammation, versus just saying something is anti-inflammatory?”

The study was published recently in the journal Molecular Nutrition & Food Research.

What is in the juice

Lycopene is a carotenoid, the class of pigments responsible for the colours of tomatoes and various other vegetables. Soy isoflavones are flavonoids that mimic the action of the hormone oestrogen. Both are phytochemicals, naturally occurring compounds that help plants thrive.

Years ago, drawing on studies that linked diets rich in either tomato products or soy with a reduced risk of prostate cancer, Ohio State researchers developed the tomato-soy juice. It was made using tomatoes bred to contain a high concentration of lycopene – varieties also developed and grown at Ohio State – and then enriched with a soy isoflavone extract.

Subsequent research at the university connected a higher intake of the tomato-soy juice with reduced prostate-specific antigen levels in some men with prostate cancer. Studies conducted elsewhere have likewise suggested that tomatoes and soy, whether eaten separately or together, can influence inflammatory and metabolic pathways tied to obesity and other chronic illnesses.

“There’s been enough compelling evidence that compounds from tomatoes and soy might be modulating inflammation that we decided to test this in people,” Cooperstone said.

How the study was carried out

For the new study, 12 healthy adults with obesity drank two 6-ounce cans of the tomato-soy juice every day for four weeks. Following a washout period, the same participants then consumed the low-carotenoid control tomato juice for a further four weeks.

The choice of comparison drink was deliberate. Rather than pitting the juice against plain water, the team selected a tomato juice stripped of the key compounds so that any difference could be attributed to those compounds specifically.

“The hypothesis is that it’s the lycopene from the tomatoes and the isoflavones from the soy that’s inducing the effect, so we didn’t want to have a control that’s just water,” Cooperstone said.

What the blood tests showed

Before and after each four-week period, the researchers collected blood samples and tested them for cytokines, the pro-inflammatory proteins produced by the immune system. Only the tomato-soy juice produced significant reductions, and it did so in three cytokines: interleukin (IL)-5, IL-12p70 and granulocyte-macrophage colony-stimulating factor (GM-CSF). The juice was also associated with a downward trend in tumour necrosis factor alpha (TNF-a), although that particular change did not reach statistical significance.

Clues from the urine analysis

The team also examined participants’ urine before and after each trial period, looking for changes in metabolites. Metabolites are the molecular products of the biochemical reactions that break down nutrients to generate energy and carry out other essential functions in the body.

The analysis revealed that both the tomato-soy juice and the control tomato juice prompted some of the same shifts in metabolite profiles, indicating that certain tomato-driven effects occurred even in the absence of lycopene. Among the changes specifically induced by the tomato-soy juice, shifts in soy isoflavone metabolites stood out. The researchers note that, while more investigation is warranted, these changes offer further evidence that the food-based intervention is acting on human biology.

“This is probably a function of the fact that there’s more to our intervention agents than just these two compounds,” Cooperstone said. “Ultimately, we want to have a better understanding of how the foods that we eat are relating to our health. And when we really want to be sure, we need to test them in clinical trials. And that’s what we’re doing here.”

Next steps: a pancreatitis trial

On the strength of these results and additional data, Cooperstone and her colleagues have received funding from the National Institute of Diabetes and Digestive and Kidney Diseases for a pilot clinical trial. That trial will test whether consuming the same tomato-soy juice reduces inflammation in people living with pancreatitis.

The team has also gathered evidence from an animal model suggesting that the tomato-soy juice can lessen both inflammation and the severity of chronic pancreatitis. Those findings support the central prediction behind the new clinical trial, namely that the intervention could improve outcomes for people with the condition.

“Care for patients with pancreatitis is palliative, focused on controlling pain and GI symptoms. Our hypothesis is that the tomato-soy juice may serve as an intervention to decrease inflammation and hopefully increase patients’ quality of life,” Cooperstone said.

Funding and contributors

The work was supported by the U.S. Department of Agriculture, the National Institutes of Health, the Lisa and Dan Wampler Endowed Fellowship for Foods and Health Research, and the Foods for Health Initiative at Ohio State.

Co-authors include first author Maria Sholola, along with Jenna Miller, Emma Bilbrey, David Francis and Thomas Mace, all of Ohio State, and Janet Navotny of the USDA. Mace is the lead principal investigator on the pancreatitis trial. Cooperstone, Philip Hart and Kristen Roberts of Ohio State are also principal investigators on that trial.

Source: Eureka Alert!

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Year-Long Trial Finds Rapid Weight Loss Outperforms a Gradual Approach, Overturning a Long-Held Assumption

Key Takeaways:

• In a 52-week randomised trial, adults living with obesity who followed a rapid weight loss programme lost significantly more weight at one year than those on a gradual programme (14.4% versus 10.5% of total body weight), and the gap held throughout the study.
  
• Rapid weight loss was not associated with greater weight regain, directly contradicting the widespread belief that losing weight slowly is necessary to keep it off.
  
• A larger share of people in the rapid weight loss group reached clinically meaningful BMI and waist-to-height targets linked to a lower 10-year risk of obesity-related conditions.
  
  
  

A long-held belief comes under scrutiny

New research presented at the European Congress on Obesity (ECO 2026) in Istanbul, Turkey, indicates that rapid weight loss (RWL) is considerably more effective than gradual weight loss (GWL), both in the amount of weight people lose and in how well that loss is sustained at one year.

For years, conventional thinking has held that rapid weight loss is unhealthy and that shedding weight very quickly raises the chance of regaining it. Yet these concerns rest largely on observational data, historical assumptions, or small studies with methodological limitations. The scientific evidence directly supporting them is limited and inconsistent, and high-quality randomised controlled trial evidence remains relatively sparse.

The study was led by Dr Line Kristin Johnson of the Department of Endocrinology, Obesity and Nutrition at Vestfold Hospital Trust in Tønsberg, Norway, together with colleagues. The centre is a collaborating centre with the European Association for the Study of Obesity (EASO-COM-Centre); EASO leads obesity advocacy and education across Europe and organises ECO.

Setting the treatment targets

A recent large, population-based cohort study concluded that, after weight loss, a body-mass index (BMI) of 27 kg/m² or below and a waist-to-height ratio (WHtR) of 0.53 or below may represent clinically meaningful treatment targets for lowering the 10-year risk of obesity-related complications, namely type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, and hip and knee osteoarthritis.

In this new study, the researchers set out to compare how effectively a rapid weight loss programme and a gradual weight loss programme helped people reach those targets.

How the trial was designed

The 52-week, investigator-initiated, randomised clinical trial was run as a collaboration between the Department of Endocrinology, Obesity and Nutrition at Vestfold Hospital Trust and Roede AS, one of Norway’s leading and most established providers of commercial weight loss programmes.

In total, 284 adults living with obesity (BMI of 30 or above), of whom 257 (90%) were women, were randomised on a one-to-one basis to one of two 16-week, food-based programmes. The rapid weight loss programme reduced energy intake in stages: under 1,000 kcal per day in weeks 1 to 8, under 1,300 kcal per day in weeks 9 to 12, and under 1,500 kcal per day in weeks 13 to 16. The gradual weight loss programme set intake at 800 to 1,000 kcal per day below each participant’s estimated total energy expenditure, with a mean self-reported intake in this group of roughly 1,400 kcal per day.

Estimated energy expenditure was calculated from each participant’s estimated resting energy expenditure and then adjusted according to whether they had low, medium, or high physical activity.

The food composition in both programmes followed current Norwegian dietary recommendations from the Norwegian Directorate of Health. Core advice included eating healthy foods such as vegetables, fruits, whole grains, low-fat dairy products, fish, eggs, lean meat, and other protein-rich foods, while limiting saturated fats and added sugars.

Maintaining the results

After the initial weight loss phase, participants in both groups moved into an identical 36-week weight-regain prevention programme.

Throughout the study, the interventions included weekly in-person group sessions from week 1 to week 16. After that, in-person group meetings took place every 14 days for the first three months, followed by monthly meetings or individual contact via webinars, video, or telephone for the remaining five months.

In these sessions, participants were advised to raise their daily energy intake by 100 to 300 kcal during the first month, until their weight stabilised. From then on, daily intake was adjusted as needed in response to any weight changes across the eight-month maintenance phase. Participants could decide for themselves whether to maintain their weight or aim for further loss, and the majority chose to keep losing weight after the initial 16-week period.

What the trial found

Of the 284 participants, 142 were randomised to the rapid weight loss programme and 142 to the gradual weight loss programme. At baseline, the rapid weight loss group had a mean age of 48.5 years, body weight of 102.4 kg, height of 169 cm, BMI of 35.8 kg/m², waist circumference of 112.5 cm, and WHtR of 0.67. The corresponding figures in the gradual weight loss group were 47.7 years, 103.0 kg, 168 cm, 36.5 kg/m², 112.8 cm, and 0.67.

The primary outcome was one-year percentage total body weight loss (%TBWL). The proportion of participants reaching a BMI of 27 kg/m² or below, or a WHtR of 0.53 or below, after one year were exploratory outcomes.

During the first 16 weeks, the rapid weight loss group lost significantly more weight than the gradual weight loss group, with a mean %TBWL of -12.9% compared with -8.1%, a between-group difference of -4.8%.

At one year, that significant difference was maintained: the mean %TBWL was -14.4% in the rapid weight loss group and -10.5% in the gradual weight loss group, a between-group difference of -3.9 percentage points.

The share of participants achieving a BMI of 27 kg/m² or below was significantly higher in the rapid weight loss group than in the gradual weight loss group at both 16 weeks (13.8% versus 0.8%) and one year (28.3% versus 9.7%). A higher proportion also reached a WHtR of 0.53 or below in the rapid weight loss group, both at 16 weeks (24.2% versus 8.9%) and at one year (33.0% versus 18.4%).

What the researchers say

The authors conclude, “Among adults with obesity, participation in a structured rapid weight loss program resulted in significantly greater weight loss at one year, and higher rates of achieving clinically meaningful BMI and WHtR targets compared with a gradual weight loss approach.

“These findings indicate that, when provided within a controlled and professionally supervised setting, rapid weight loss may represent a more effective method than gradual weight loss for reaching key body weight targets associated with reduced obesity-related health risks.”

Dr Johnson adds, “Our results clearly challenge the prevailing belief that slow and steady gradual weight loss is necessary to prevent weight regain and reduce obesity-related complications.

“By contrast, we show that rapid weight loss is not associated with weight regain, and, more importantly, that a larger proportion of participants undergoing rapid weight loss – compared with gradual weight loss – achieved clinically meaningful treatment targets for reducing the 10-year risk of type 2 diabetes, hypertension, atherosclerotic cardiovascular disease, and hip/knee osteoarthritis.

“These findings are particularly relevant given the urgent need for effective weight-loss and weight-maintenance strategies. As many individuals with obesity cannot access or afford medical or surgical treatments, our results support the potential of effective, commercially available weight-reduction programs to help reduce the growing burden on public health care systems.”

Why it matters

With obesity placing a rising strain on health systems, and with medical and surgical treatments out of reach for many, the trial points to professionally supervised commercial programmes as a potential route to meaningful, lasting results. Its central message reframes a long-standing assumption: under proper supervision, losing weight quickly did not undermine maintenance, and it helped more people reach the targets tied to lower long-term health risks.

CCH insights:

These are impressive results for a diet and lifestyle intervention, with both groups achieving greater than 10% total body weight loss over a period of a year. However, participants received fairly intensive support throughout the entire year of the trial. The important thing is what happens in the next 12 months, after the intervention has stopped – are they able to sustain behavioural changes and weight loss without the support from the programme?

Source: Medical Xpress

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AI-Powered Whole-Body Mapping Reveals Obesity’s Hidden Impact on Facial Nerves

Key Takeaways: 

• Researchers have developed an AI-driven whole-body imaging platform called MouseMapper that can analyse disease-related changes across an entire mouse body at cellular-level resolution.
  
• Using the system, scientists identified widespread inflammation and previously unknown damage to facial sensory nerves linked to obesity.
  
• Similar molecular patterns were also detected in human tissue, suggesting that obesity-related nerve changes observed in mice may also occur in people.
  
  
  

A new way to study disease across the entire body

Researchers from Helmholtz Munich, Ludwig Maximilians University Munich (LMU), and several collaborating institutions have developed a powerful artificial intelligence-based imaging system capable of mapping disease-related changes throughout an entire mouse body in extraordinary detail.

The new platform, known as MouseMapper, combines advanced whole-body imaging with foundation-model-based AI to examine how diseases affect organs, nerves, immune cells, and tissues simultaneously. Using the system, the research team uncovered widespread inflammation and previously unrecognised nerve damage associated with obesity.

The findings, published in Nature, also revealed similar molecular signatures in human tissue, suggesting that some obesity-related nerve damage mechanisms may occur in both mice and people.

Obesity is increasingly recognised as a complex disease that affects far more than body weight and metabolism. It can alter immune activity, disrupt nerve structures, and reshape tissues across the body, contributing to conditions including type 2 diabetes, cardiovascular disease, stroke, neuropathy, and cancer. However, despite these systemic effects, researchers have lacked technologies capable of studying disease-related changes throughout an intact body at high resolution.

To address this limitation, the research team led by Professor Ali Ertürk, Director of the Institute for Biological Intelligence (iBIO) at Helmholtz Munich and Professor at LMU, created MouseMapper.

The AI framework uses deep learning algorithms based on foundation models to analyse enormous whole-body imaging datasets. The system can automatically identify and segment 31 different organs and tissue types while simultaneously mapping nerves and immune cells throughout the body.

This enables scientists to investigate how diseases affect multiple organ systems at the same time rather than analysing tissues individually.

“MouseMapper is built on a foundation model, which means it generalizes far beyond the data it was originally trained on,” says Ying Chen, co-first author of the study.

Transparent mice enable deep whole-body imaging

To generate the body-wide maps, the researchers first labelled nerves and immune cells in mice using fluorescent markers that glow under microscopic imaging.

The team then used specialised tissue-clearing techniques to render the mice transparent while preserving the fluorescent signals. This allowed scientists to visualise structures deep inside the body without physically cutting tissues into sections.

Researchers next employed advanced light-sheet microscopy to produce highly detailed three-dimensional images of entire mice. These scans generated extremely large datasets containing tens of millions of cellular structures distributed across multiple organs and tissues.

MouseMapper then processed the data automatically, identifying anatomical structures, nerve networks, and clusters of immune cells throughout the animals.

Unlike conventional approaches that require scientists to select specific tissues or regions for analysis beforehand, the system enabled the researchers to examine disease-related changes across the whole organism simultaneously.

This whole-body approach allowed the team to pinpoint where inflammation and tissue damage were occurring in organs including fat tissue, muscle, liver, and peripheral nerves.

Obesity found to alter facial sensory nerves

To investigate how obesity affects the body, the researchers fed mice a high-fat diet that induced obesity and metabolic disturbances similar to those observed in humans.

Using MouseMapper, the scientists identified widespread changes in both immune-cell organisation and nerve structures throughout the body.

One of the most unexpected findings involved the trigeminal nerve, a major facial nerve responsible for transmitting facial sensations and supporting certain motor functions.

The researchers discovered that obese mice showed a substantial reduction in nerve branches and sensory nerve endings within these facial nerves, suggesting impaired nerve function.

Behavioural testing supported this observation. Obese mice demonstrated reduced responsiveness to sensory stimulation compared with lean mice, indicating that the structural changes may have functional consequences.

Molecular changes detected in facial nerve tissue

The team then carried out a more detailed investigation of the trigeminal ganglion, the structure that contains the cell bodies of facial sensory neurons.

Using spatial proteomics analysis, the researchers identified molecular alterations associated with inflammation and nerve remodelling within the trigeminal ganglion.

Importantly, many of the same molecular signatures identified in mice were also found in trigeminal tissue samples from people living with obesity.

This suggests that the nerve-related changes observed in the animal models may also occur in humans.

“We revealed previously unknown structural and molecular changes in the trigeminal ganglion and its facial branches, and the same molecular signature was conserved in human tissue. This kind of finding simply cannot emerge from studying one organ at a time,” says Dr. Doris Kaltenecker, senior scientist at the Institute for Diabetes and Cancer (IDC) at Helmholtz Munich and first author of the study.

Potential applications beyond obesity

The researchers believe MouseMapper could become an important platform for studying diseases that affect multiple organ systems simultaneously.

Potential future applications include research into diabetes, cancer, neurodegenerative diseases, and autoimmune disorders.

Unlike traditional methods that focus on isolated tissues or organs, MouseMapper provides an integrated whole-body analysis system capable of identifying disease “hotspots” throughout an organism.

The research team has also made the whole-body datasets publicly available online, allowing scientists worldwide to explore obesity-related changes across tissues and organs.

“Our goal is to create a comprehensive framework for understanding how diseases affect the body as an interconnected system,” says Ali Ertürk.

“Our long-term vision is to build truly realistic digital twins of mice in health and disease: cell-level atlases that we can query, perturb and screen in silico computationally. That would let us pinpoint the earliest changes a disease causes, design interventions to prevent them, and accelerate the discovery of new treatments while reducing the number of physical experiments we need to run.”

Research funding and support

The study received support from multiple funding organisations and research initiatives, including the European Research Council, the German Research Foundation under Germany’s Excellence Strategy, the Munich Cluster for Systems Neurology (SyNergy), the German Federal Ministry of Education and Research, the Vascular Dementia Research Foundation, the Nomis Foundation, the Else-Kröner-Fresenius-Stiftung, the Edith-Haberland-Wagner Stiftung, the Helmut Horten Foundation, the EFSD and Novo Nordisk A/S Programme for Diabetes Research in Europe, and the China Scholarship Council.

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Genetics May Help Explain Why GLP-1 Weight-Loss Drugs Work Better for Some People Than Others

Key Takeaways: 

• Researchers have identified two genetic variants that may help explain why people respond differently to GLP-1 weight-loss medications such as Wegovy and Mounjaro.
  
• One genetic variant was linked to slightly greater weight loss, while another appeared to increase the likelihood of nausea and vomiting in people taking tirzepatide.
  
• Experts say the findings are important for understanding treatment variability, but non-genetic factors such as sex, medication type, dosage and treatment duration still appear to play a much larger role.
  
  
  

Genetic differences may help explain variable responses to GLP-1 weight-loss drugs

Scientists have uncovered new evidence suggesting that genetics may partly explain why GLP-1 weight-loss medications produce very different results from one person to another.

The research, published in Nature, examined how specific genetic differences may influence both weight-loss outcomes and the risk of side-effects in people taking glucagon-like peptide-1 receptor agonists, commonly known as GLP-1 drugs.

The findings could eventually contribute to more personalised approaches to obesity treatment, where therapies are selected based on an individual’s biological profile. However, researchers and independent experts stressed that the genetic effects identified in the study were relatively modest and are not yet strong enough to guide routine clinical decisions.

GLP-1 medicines and their growing role in obesity care

GLP-1 receptor agonists, including semaglutide, sold under the brand name Wegovy, and tirzepatide, marketed as Mounjaro, mimic naturally occurring gut hormones involved in regulating appetite, digestion and insulin release.

These medicines have transformed obesity treatment in recent years and are now used by millions of people globally. By helping reduce appetite and slow gastric emptying, they can support significant weight loss in many individuals.

However, clinical experience and research have consistently shown substantial variation in treatment response. Some people lose large amounts of weight, while others experience more limited benefits. Similarly, side-effects such as nausea and vomiting can vary considerably between individuals.

Until now, the biological reasons behind these differences have remained poorly understood.

Large genetic analysis involving nearly 28,000 people

To investigate the issue, researchers from 23andMe and a nonprofit medical research institute analysed data from 27,885 people taking GLP-1 medications.

The study focused on variations in genes linked to gut hormone pathways that regulate appetite and digestion.

Researchers identified one GLP1 receptor variant, known as rs10305420, that was associated with slightly greater weight loss among people carrying the variant compared with those who did not carry it.

A second genetic variant, rs1800437, was linked to a greater likelihood of nausea and vomiting in people taking tirzepatide. However, this variant was not associated with the amount of weight lost.

The findings suggest that inherited genetic differences may contribute to how people respond to GLP-1 therapies, both in terms of effectiveness and tolerability.

Genetics appears to play only a modest role

Despite the findings, researchers emphasised that the overall contribution of genetics appeared relatively small.

Marie Spreckley, an obesity expert at the University of Cambridge who was not involved in the study, said the research offered biologically plausible evidence that genetic variation may influence treatment outcomes.

“However, the magnitude of these genetic effects is small in clinical terms,” she said. “Importantly, non-genetic factors such as sex, drug type, dose and duration appear to explain a substantially larger proportion of variability. The authors’ model suggests that most of the explained variance comes from these factors, with genetics adding only a modest incremental contribution.

“In terms of how this fits with the wider evidence, it reinforces that while there is substantial variability in response to GLP1 therapies, genetics is only one part of a much more complex picture. Behavioural, clinical and treatment-related factors remain the dominant drivers of outcomes.

“Overall, this is an important step toward understanding variability and the potential for future precision approaches, but the effects are modest and the evidence is not yet sufficient to support using genetic information to guide treatment decisions in routine clinical practice.”

Toward more personalised obesity treatment

The findings contribute to a growing body of research exploring precision medicine approaches in obesity care.

As scientists continue to investigate why individuals respond differently to treatments, future obesity management may increasingly incorporate biological, behavioural and clinical information to tailor therapies more effectively.

However, experts caution that current evidence does not support the use of genetic testing to determine which GLP-1 medication a person should receive.

Instead, the study primarily advances understanding of the complex biological factors that may influence treatment response, while reinforcing that genetics represents only one piece of a much larger puzzle involving lifestyle, clinical characteristics and medication-related factors.

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Weight Loss Drugs Linked to Lower Risk of Peptic Ulcer Disease in Adults with Diabetes

Key Takeaways: 

• A large US study involving more than 66,000 adults found that people with type 2 diabetes using GLP-1 receptor agonists had significantly lower odds of developing peptic ulcer disease.
  
• Researchers observed a 44 percent lower likelihood of peptic ulcer disease among GLP-1 users overall, with a 56 percent lower risk seen in people who switched from metformin to a GLP-1 medication instead of insulin.
  
• The findings add to growing evidence that GLP-1 receptor agonists may have anti-inflammatory and gastrointestinal protective effects beyond blood sugar control and weight management.
  
  
  

Study suggests potential gut benefits of GLP-1 medications

Medications commonly prescribed for type 2 diabetes and obesity management may provide an additional benefit beyond blood sugar control and weight reduction. A large nationwide study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) has found that people with type 2 diabetes who used GLP-1 receptor agonists were significantly less likely to develop peptic ulcer disease compared with those who did not use these medications.

The findings were published in Clinical Gastroenterology and Hepatology and were based on electronic health record data from more than 66,000 adults participating in the National Institutes of Health’s All of Us Research Program. The programme is considered one of the most diverse biomedical research datasets in the United States.

“Peptic ulcer disease remains a significant cause of illness and hospitalization, particularly among people with type 2 diabetes, yet large-scale clinical studies examining how newer diabetes medications affect ulcer risk have been lacking,” said Trisha Pasricha, MD, MPH, a gastroenterologist at BIDMC. “Our study was designed to address that gap and to better understand whether GLP1 receptor agonists are associated with meaningful differences in ulcer risk in this population.”

Understanding peptic ulcer disease in diabetes

Peptic ulcers are painful open sores that develop in the lining of the stomach or upper part of the small intestine. Symptoms can include ongoing abdominal pain, nausea, indigestion, and bloating. In more severe cases, ulcers can lead to complications such as gastrointestinal bleeding or perforation.

Globally, around four million people experience ulcer-related complications each year.

People living with type 2 diabetes are known to have a higher risk of developing peptic ulcer disease. Researchers believe this increased vulnerability may stem from a combination of chronic inflammation, metabolic stress, impaired tissue repair, and greater exposure to medications associated with ulcer formation, particularly nonsteroidal anti-inflammatory drugs (NSAIDs).

Because of this elevated risk, researchers sought to investigate whether GLP-1 receptor agonists, which were first approved for diabetes treatment approximately two decades ago and are now widely used for both diabetes and obesity care, might influence ulcer risk.

GLP-1 use associated with lower ulcer risk

The researchers found that the use of GLP-1 medications was associated with substantially lower odds of being diagnosed with peptic ulcer disease.

Across the full study population, people with type 2 diabetes using GLP-1 receptor agonists had a 44 percent lower likelihood of receiving a peptic ulcer diagnosis compared with people not using these medications. The association remained even after adjusting for factors including age, sex, body mass index, medication use, and other clinical variables.

The investigators also carried out a more focused comparison involving people who had discontinued metformin, which remains the standard first-line therapy for type 2 diabetes. Researchers examined participants who then transitioned either to a GLP-1 medication or to insulin therapy.

In this head-to-head analysis, people who switched to a GLP-1 receptor agonist had a 56 percent lower risk of developing peptic ulcer disease compared with those who switched to insulin.

Researchers point to possible anti-inflammatory effects

Although GLP-1 receptor agonists are not currently prescribed for ulcer prevention, researchers believe the findings may reflect broader biological effects of the medications.

“Although these medications are not prescribed with ulcer prevention in mind, there is growing evidence that GLP1 receptor agonists may have broader biological effects, including anti-inflammatory properties and roles in gastrointestinal mucosal protection,” said senior author Pasricha, who is also an assistant professor of medicine at Harvard Medical School. “Those effects may help explain why we observed different ulcer risks compared with insulin.”

GLP-1 receptor agonists are best known for improving blood glucose control, supporting weight loss, and reducing cardiovascular risk in people with type 2 diabetes and obesity. However, a growing body of research suggests these drugs may also reduce inflammation and support tissue repair within the gastrointestinal tract.

The authors noted that more research is needed to determine whether these effects directly improve the stomach and small intestine’s ability to resist injury, particularly in people with diabetes who may already have impaired protective mechanisms.

Findings strengthened by known risk factors

The investigators also observed that medications already known to increase ulcer risk behaved as expected within the dataset. NSAIDs, corticosteroids, and blood thinners were all associated with increased ulcer risk, supporting the reliability of the study’s methodology.

Taken together, the researchers said the findings strengthen the observed association between GLP-1 receptor agonist use and lower rates of peptic ulcer disease.

Study authors and funding

Co-authors of the study included Philippa Seika, Jocelyn Chang, Su Min Hong, Sarah Ballou, Vikram Rangan, Chethan Ramprasad, Johanna Iturrino, Judy Nee, and Subhash Kulkarni of BIDMC; Christian Denecke of Charité Universitätsmedizin; and Anthony Lembo of Cleveland Clinic.

The study was funded by the American Gastroenterological Research Foundation’s Research Scholar Award, the National Institute on Aging, the Diacomp Foundation, a Pilot Grant from the Harvard Digestive Disease Core, and the Walter Benjamin Fellowship from the Deutsche Forschungsgemeinschaft.

The authors reported no conflicts of interest.

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Bariatric Surgery Delivers Greater Weight Loss and Disease Remission Than GLP-1 Drugs, Large Analysis Finds

Key Takeaways:

• A large real-world analysis involving more than 430,000 patients found that metabolic and bariatric surgery produced substantially greater weight loss than GLP-1 medications after 12 months.
  
• Surgery was associated with higher remission rates for obesity-related conditions including type 2 diabetes, hypertension and high cholesterol.
  
• Researchers and clinicians said GLP-1 medications represent an important advance in obesity care, but cautioned that they should not be viewed as a replacement for metabolic and bariatric surgery in people requiring more substantial and durable outcomes. 
  
  
  

Surgery outperformed GLP-1 drugs across key outcomes

Metabolic and bariatric surgery may provide significantly greater weight loss and higher rates of obesity-related disease remission than glucagon-like peptide-1 receptor agonist medications, according to a major new real-world comparison presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) Annual Meeting 2026.

The systematic review and analysis, described as one of the largest and most comprehensive comparisons of the two treatment approaches to date, evaluated data from 30 clinical studies involving more than 430,000 patients. Researchers found that although both treatments produced meaningful clinical benefits for people living with obesity, metabolic and bariatric surgery consistently outperformed GLP-1 therapies across all major outcomes assessed.

The research was conducted by investigators from Yale School of Medicine, Coreva-Scientific, Vanderbilt University and UT Health San Antonio.

Greater weight loss after surgery

According to the findings, people who underwent metabolic and bariatric surgery experienced more than 20% greater weight loss at 12 months compared with those treated with GLP-1 receptor agonist medications.

Researchers also reported that surgery was linked to substantially higher remission rates for several obesity-related health conditions. Compared with GLP-1 therapy, metabolic and bariatric surgery was associated with:

• 42% higher remission rates for type 2 diabetes
• 12.8% higher remission rates for hypertension
• 20.8% higher remission rates for high cholesterol

The analysis focused specifically on studies that directly compared bariatric surgery with GLP-1 receptor agonists. Studies that combined surgery and medication therapies were excluded from the review.

The primary endpoint examined was weight loss at 12 months. Secondary endpoints included remission of obesity-related conditions such as type 2 diabetes, hypertension and hyperlipidaemia.

Researchers highlight durability of surgical outcomes

The study authors noted that although GLP-1 medications have transformed obesity treatment and expanded evidence-based care options, metabolic and bariatric surgery continues to deliver greater and more durable results for many patients.

“While GLP-1 medications are an important advance, they do not match the magnitude or durability of outcomes achieved with metabolic and bariatric surgery, which remains one of the most underutilized treatments in medicine. Once the medications are discontinued, whether due to side effects, cost or other factors, their benefits often diminish or disappear, whereas the benefits of surgery endure.” – John M. Morton, MD, MPH, FASMBS, Study Co-Author, Professor of Surgery and Vice-Chair, Quality, Surgery at Yale School of Medicine

The findings add to ongoing discussions within obesity care about how best to position GLP-1 therapies and surgical interventions within long-term treatment pathways.

Evidence gap in direct comparisons

Despite the rapid growth in the use of GLP-1 medications such as semaglutide and tirzepatide, researchers noted that direct comparisons between these drugs and bariatric surgery remain limited.

The review involved a comprehensive search of PubMed and EMBASE databases to identify relevant studies comparing the two treatment approaches.

Commenting on the findings, an independent obesity surgery expert said the analysis helps address a major evidence gap in the field.

“Despite the explosive growth of GLP-1 drugs, no randomized controlled trials have directly compared them to bariatric surgery. This analysis helps fill that evidence gap,” said John Scott, MD, FACS, FASMBS, clinical professor of surgery at the University of South Carolina School of Medicine Greenville and metabolic and bariatric surgery director for Prisma Health, who was not involved in the study.

“GLP-1s have expanded evidence-based treatment options, but they should not be seen as a replacement for surgery – especially for patients who require the level of outcomes that only metabolic and bariatric surgery can provide.”

Expanding treatment options in obesity care

The findings come amid growing global interest in obesity treatment strategies as the use of GLP-1 receptor agonists continues to rise rapidly. Medications in this class have demonstrated significant effectiveness for weight reduction and metabolic health improvement, but concerns remain regarding long-term adherence, cost, side effects and weight regain after discontinuation.

Metabolic and bariatric surgery, meanwhile, has long been associated with substantial and sustained weight loss as well as improvements in obesity-related conditions such as type 2 diabetes and cardiovascular risk factors. However, experts have repeatedly argued that surgery remains significantly underutilised despite its established effectiveness.

The researchers concluded that while both treatment approaches play an important role in obesity management, metabolic and bariatric surgery continues to provide the most substantial improvements in weight loss and disease remission outcomes based on current comparative evidence.

Source: American Society for Metabolic and Bariatric Surgery

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Walking 8,500 Steps a Day May Help Prevent Weight Regain, Study Finds

Key Takeaways:

• New research presented at ECO 2026 suggests that walking around 8,500 steps a day may help people maintain weight loss and reduce the risk of weight regain after dieting.
  
• Researchers found that people who increased and sustained their daily step count were more successful at keeping weight off over the long term.
  
• The study highlights walking as a simple, affordable, and accessible strategy that could support long-term obesity management.
  
  
  

Study explores the role of walking in long-term weight management

New research being presented at the European Congress on Obesity (ECO 2026) in Istanbul, Turkey, taking place from May 12–15, suggests that walking approximately 8,500 steps per day could help people avoid regaining weight after dieting.

The findings, which will also be published in the International Journal of Environmental Research and Public Health, address one of the biggest challenges in obesity care – maintaining weight loss over time.

Although many weight loss programmes encourage people to increase their daily physical activity, including walking, researchers say there has been relatively limited evidence examining whether higher step counts genuinely help people lose weight during dieting or maintain that weight loss afterwards.

The new study aimed to clarify whether walking more each day could reduce the likelihood of weight regain and identify what level of daily activity may be most beneficial.

Preventing weight regain remains a major challenge

Professor Marwan El Ghoch, from the Department of Biomedical, Metabolic and Neural Sciences at the University of Modena and Reggio Emilia in Italy, highlighted the importance of addressing weight regain in obesity treatment.

“The most important – and greatest – challenge when treating obesity is preventing weight regain,” explained Professor El Ghoch.

“Around 80% of people with overweight or obesity who initially lose weight tend to put some or all of it back on again within three to five years.

“The identification of a strategy that would solve this problem and help people maintain their new weight would be of huge clinical value.”

Long-term weight maintenance is widely recognised as one of the most difficult aspects of obesity management. While many people can initially lose weight through dietary changes, sustaining those results often proves far more challenging due to complex biological, behavioural, and environmental factors.

Researchers conducted a large systematic review and meta-analysis

To explore the relationship between walking and long-term weight management, Professor El Ghoch and colleagues from Italy and Lebanon carried out a systematic review and meta-analysis of existing research.

The researchers analysed 18 randomised controlled trials investigating walking and weight management strategies. Fourteen of those studies, involving a total of 3,758 adults, were included in the final meta-analysis.

Participants had an average age of 53 years and an average body mass index (BMI) of 31 kg/m², placing the average participant in the obesity category. The studies included participants from a range of countries, including the United Kingdom, United States, Australia, and Japan.

The trials compared two groups:

• 1,987 participants enrolled in lifestyle modification (LSM) programmes
• 1,771 participants assigned to control groups

The control groups either followed dieting programmes without additional support or received no treatment intervention.

Lifestyle programmes combined diet and increased walking

The lifestyle modification programmes combined dietary guidance with recommendations to increase walking and monitor daily step counts.

These interventions generally included two distinct phases:

1. An initial weight loss phase
2. A longer-term maintenance phase designed to help participants sustain weight loss

Researchers assessed participants’ daily step counts at multiple time points throughout the studies, including:

• At baseline
• After the weight loss phase
• After the maintenance phase

The average duration of the weight loss phase was 7.9 months, while the maintenance phase lasted an average of 10.3 months.

At the start of the studies, physical activity levels were similar in both groups. Participants in the lifestyle modification programmes averaged 7,280 steps per day, while participants in the control groups averaged 7,180 daily steps.

Higher step counts were associated with less weight regain

The researchers found that participants in the control groups did not significantly increase their daily walking levels and did not experience meaningful weight loss during the studies.

In contrast, participants enrolled in the lifestyle modification programmes increased their average daily step count to 8,454 steps by the end of the weight loss phase.

During this period, participants lost an average of 4.39% of their body weight, equivalent to approximately 4 kg.

Importantly, participants were largely able to maintain their higher levels of daily activity throughout the maintenance phase. By the end of the studies, they were still averaging 8,241 steps per day.

They also maintained most of their weight loss over the longer term, with an average sustained weight reduction of 3.28%, or roughly 3 kg.

Further analysis demonstrated a clear association between higher daily step counts and lower levels of weight regain.

Researchers found that people who increased their walking during the weight loss phase and sustained those higher activity levels afterwards were more successful at maintaining weight loss over time.

Walking appeared more important for weight maintenance than initial weight loss

Interestingly, the study found that walking more was not associated with greater weight loss during the initial dieting period itself.

Researchers suggested this may be because calorie reduction and dietary changes tend to have a stronger influence on short-term weight loss than physical activity alone.

However, physical activity appeared to play a more significant role in helping people sustain weight loss once it had been achieved.

This distinction is important because many obesity interventions focus heavily on initial weight reduction, despite evidence showing that long-term maintenance is often the more difficult challenge.

A simple and affordable intervention

Professor El Ghoch said the findings demonstrate that lifestyle modification programmes incorporating walking can support clinically meaningful long-term weight management.

He added:

“Participants should be always encouraged to increase their step count to approximately 8,500 a day during the weight loss phase and sustain this level of physical activity during the maintenance phase to help prevent them from regaining weight.

“Increasing the number of steps walked to 8,500 each day is a simple and affordable strategy to prevent weight regain.”

The researchers suggest that walking may represent a practical and accessible intervention that could be incorporated into obesity treatment programmes without the need for expensive equipment or specialist facilities.

As obesity rates continue to rise globally, strategies that are sustainable, low-cost, and easy to implement may become increasingly important in supporting long-term health outcomes.

CCH insight

The evidence increasingly points to sustained behaviour change – not just the initial loss – as the real challenge in obesity care. CCH’s Obesity Essentials CPD short course (8–10 hours, fully online, CPD-accredited) gives healthcare professionals the practical skills to assess, support and manage patients with overweight and obesity, including how to help them build and maintain the everyday habits, such as regular walking, that keep weight off for good.
Explore Obesity Essentials →

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Obesity Identified as Key Driver of Rising Cancer Rates in Younger Adults

Key Takeaways: 

• A major new study has found that overweight and obesity are likely to be significant contributors to rising cancer rates among younger adults in England.
  
• Researchers found that many traditional behavioural cancer risk factors – including smoking, alcohol consumption and physical inactivity – have remained stable or improved over the past two decades, making them unlikely to fully explain the increase in early-onset cancers.
  
• Although excess weight appears to play an important role, researchers say it cannot entirely account for the rise in cancers such as bowel cancer, suggesting that additional biological, environmental and early-life factors may also be involved.
  
  
  

Study highlights growing concern over early-onset cancer

Being overweight or living with obesity may be a key driver behind rising cancer rates in younger adults in England, according to a major new study led by researchers at The Institute of Cancer Research, London, and Imperial College London.

The analysis, published in BMJ Oncology, examined trends in cancer incidence alongside changes in known behavioural cancer risk factors over nearly two decades. Researchers found that while rates of several cancers among younger adults have continued to increase, many established lifestyle-related risk factors have either improved or remained stable during the same period.

These findings led researchers to conclude that obesity is likely to be one of the most important contributors to the increase in cancer incidence among younger generations in England.

At the same time, the researchers stressed that rising body mass index (BMI) alone does not fully explain the growing number of cancer cases, indicating that additional factors may also be contributing to the trend.

Researchers analysed cancer trends across England

The research team used national cancer registry data from England covering the years 2001 to 2019. The study was conducted by scientists from the Cancer Epidemiology and Prevention Research Unit (CEPRU) at both The Institute of Cancer Research (ICR) and Imperial College London.

Researchers examined incidence trends across:

• 22 cancer types in women
• 21 cancer types in men

From this analysis, they identified 11 cancers that are increasing among adults aged between 20 and 49 years and are associated with known behavioural risk factors.

All of the cancers identified – except oral cancer – are recognised as being linked to excess weight.

For most cancer types, increases seen in younger adults mirrored trends observed in adults aged over 50, where the overall disease burden remains considerably higher. However, bowel cancer and ovarian cancer stood out as notable exceptions because rates were increasing only among younger age groups.

Most traditional risk factors have improved

The study examined trends in several well-established behavioural cancer risk factors, including:

• Smoking
• Alcohol use
• Overweight and obesity
• Physical inactivity
• Red and processed meat consumption
• Low fibre intake

Together, these risk factors accounted for an estimated 40–50 per cent of bowel, endometrial, oral and liver cancer cases in 2019.

However, researchers found that trends for most of these risk factors have either remained stable or improved over time, making them unlikely to substantially explain the recent rise in cancer incidence among younger adults.

According to the analysis:

• Smoking among younger adults has fallen by approximately two per cent annually over the past two decades.
• Alcohol consumption has largely stabilised or declined.
• Physical inactivity has decreased.
• Consumption of red and processed meat has reduced.
• Fibre intake, while still below recommended levels, has gradually improved.

In contrast, rates of overweight and obesity have steadily increased since 1995.

The largest increases in obesity were observed among younger women, where obesity prevalence rose by approximately 2.6 per cent relative increase per year.

Obesity linked to rising bowel cancer rates

The researchers found evidence linking rising BMI to increasing bowel cancer rates among younger adults.

Among younger women, bowel cancer rates associated with BMI rose from 0.9 to 1.6 cases per 100,000 people. In comparison, bowel cancer rates not attributable to BMI increased from 6.4 to 9.6 cases per 100,000 people.

Similar patterns were also observed in men.

However, the authors emphasised that the total number of BMI-linked bowel cancer cases remained lower than the number of cases not linked to BMI. This suggests that although obesity is an important contributor, it cannot fully explain the scale of the increase in bowel cancer among younger adults.

Additional causes may be contributing

The study points to the likelihood that multiple interacting factors are contributing to rising cancer rates in younger generations.

Several suspected contributors have previously been proposed, including:

• Ultra-processed foods
• Antibiotic use
• Air pollution

However, researchers noted that many of these exposures have also shown relatively stable or declining trends in the UK, complicating efforts to identify the main drivers of early-onset cancers.

The authors also highlighted emerging evidence suggesting that obesity-related mechanisms not fully captured by BMI may influence cancer risk. These include:

• Metabolic dysfunction
• Chronic inflammation
• Alterations in the gut microbiome

Further research is needed to determine whether these mechanisms directly contribute to the development of bowel cancer and other cancers in younger adults.

Experts say more research is urgently needed

The researchers called for large-scale, long-term studies capable of tracking exposures across the entire life course in order to better understand what is driving rising rates of early-onset cancers.

Professor Marc Gunter, Co-Director of the Cancer Epidemiology and Prevention Research Unit at Imperial College London, said:

“The changes we’re seeing in cancer incidence, particularly the rates of some cancers in younger adults, don’t have a single cause or a simple answer. They reflect a complex mix of generational effects, gaps in long-term exposure data, and shifts in diagnosis and detection, and show how much more scientists still need to understand about when and how cancer develops across the life course. While rising rates in younger adults are concerning, it remains crucial not to lose sight of cancer trends in older adults, where the absolute burden of disease is still far greater.”

Professor Montserrat García-Closas, Co-Director of the Cancer Epidemiology and Prevention Research Unit and Group Leader in Integrative Cancer Epidemiology at The Institute of Cancer Research, London, said the findings indicate that behavioural changes alone cannot explain current trends.

She said:

“Our findings show that while cancer rates are rising in younger adults, the trends are unlikely to be explained by changes in most known behavioural risk factors. Smoking, alcohol and other behaviours have been stable or improving for two decades, yet early-onset cancers continue to increase – particularly bowel cancer.

“Excess weight is an important contributor, although it cannot fully account for the scale of the rise in bowel and other cancers. This tells us that multiple factors – including early-life exposures – may be acting together. Understanding these patterns is essential for identifying what is truly driving cancer risk in today’s generations. We now need deeper research, better measurement and continued surveillance to uncover the causes behind these worrying trends.

“However, we cannot wait to act. Tackling obesity across all ages, particularly in children and young people, through stronger public health policies and wider access to effective interventions, could slow the rise in cancer and prevent many cancers – and must become a national priority.”

Calls for stronger prevention and public health action

The findings have prompted renewed calls for stronger public health measures aimed at preventing obesity and improving cancer prevention strategies across all age groups.

Professor Kristian Helin, CEO of The Institute of Cancer Research, London, said the study highlights an urgent public health challenge requiring coordinated action across research, prevention and policy.

He said:

“This work highlights a growing public health challenge and the need for urgent action across research, prevention and policy. Although rising cancer rates in younger adults are concerning, the burden remains overwhelmingly higher in older people, which means prevention efforts must span all ages.

“This study makes clear that traditional lifestyle risks alone cannot explain current trends – pointing to the importance of investigating other exposures such as the potential role of the microbiome, while strengthening strategies to address obesity and other established risks. To protect future generations, we must invest in understanding the causes of cancer at all ages and ensure that early diagnosis, screening and prevention strategies keep pace with a changing population.”

CCH insights:

The outcomes of this study are concerning but not entirely surprising, given that obesity rates in children and young people are still rising and obesity is a significant risk factor for many cancers. It adds further support for the call to treat obesity at the earliest opportunity, regardless of the age of the individual. The longer obesity goes untreated the greater the risk of individuals developing serious chronic diseases such as cancer, type 2 diabetes and heart disease.

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People Judge Weight Loss More Harshly When GLP-1 Drugs Are Used, Study Finds

Key Takeaways:

• People using GLP-1 and other anti-obesity medications were consistently judged more negatively than those losing weight through diet and exercise alone.
  
• Researchers found that anti-obesity medication users were perceived as putting in less effort and were therefore viewed as less moral, competent, warm, and deserving of their success.
  
• The findings suggest that stigma surrounding obesity treatment may discourage people from seeking effective medical care and reinforce harmful misconceptions about obesity and weight loss.
  
  
  

Study explores social attitudes toward weight loss medication

A recent study published in Scientific Reports has found that people who lose weight using anti-obesity medications (AOMs), including glucagon-like peptide-1 (GLP-1) receptor agonists, are often judged more harshly than those who lose weight through diet and exercise alone.

The research examined how the use of anti-obesity medication influences perceptions of effort, morality, competence, warmth, and deservingness. The findings suggest that social attitudes toward obesity treatment remain strongly shaped by beliefs about personal effort and self-control.

With more than one billion people worldwide living with obesity, the researchers noted that how a person loses weight can significantly influence how others perceive them. Although GLP-1 receptor agonists and other anti-obesity medications have demonstrated substantial effectiveness in treating obesity, they are frequently criticised as an “easy way out.”

According to the researchers, this perception reflects a broader psychological phenomenon known as effort moralization – the tendency to associate greater effort with greater moral worth.

The authors explained that such beliefs may reinforce obesity stigma, discourage people from seeking treatment, and negatively affect both physical and mental health outcomes.

While anti-obesity medications can provide important medical support for people living with persistent obesity, the researchers stressed that understanding the social impact of these perceptions is necessary if the full potential of these treatments is to be realised.

Four studies conducted across three countries

The research involved four pre-registered experimental studies conducted between November 2024 and February 2025 in Belgium, the United States, and the United Kingdom.

In total, 1,205 participants took part in the research. Participants were recruited online through university participant pools and the Prolific platform. Researchers applied several quality-control measures, excluding incomplete responses, failed attention checks, overly rapid responses, and participants with insufficient language proficiency.

Across the studies, participants were presented with descriptions of two individuals who shared identical weight-loss goals and similar experiences with diet and exercise. The only difference between the individuals was that one used an anti-obesity medication while the other did not.

Participants then rated both individuals using Likert-type scales assessing:

• Perceived effort
• Moral character
• Warmth
• Competence
• Deservingness of weight-loss success
• Willingness to cooperate with them in future scenarios

The researchers also explored several additional variables across the studies, including:

• General attitudes toward anti-obesity medication
• Personal or social experience with weight-loss medication
• Beliefs that anti-obesity medication represents a “shortcut”
• Personality traits measured using the Big Five Inventory (BFI)

To analyse the data, the researchers used t-tests, correlations, multilevel modelling, and evidence synthesis techniques.

Anti-obesity medication users viewed more negatively

Across all four studies, the findings revealed a consistent pattern of negative social judgement toward individuals using anti-obesity medication.

Compared with people relying solely on diet and exercise, anti-obesity medication users were perceived as putting in less effort into achieving their weight-loss goals.

This perception of lower effort was strongly linked to harsher moral evaluations. Participants consistently rated anti-obesity medication users as less moral than non-users.

In Study 1, for example, significantly lower perceived effort ratings for anti-obesity medication users were accompanied by similarly large reductions in moral character ratings.

The bias extended beyond morality alone.

Participants also viewed anti-obesity medication users as:

• Less competent
• Less warm
• Less deserving of their success

In addition, participants reported lower anticipated satisfaction with future cooperation involving anti-obesity medication users in a hypothetical training-partner scenario.

According to the paper’s evidence synthesis, most of these effects were large, although the effect relating to warmth was more moderate.

Perceived effort was closely tied to moral judgement

One of the most significant findings was the strong relationship between perceived effort and moral judgement.

Across all four studies, larger differences in perceived effort between medication users and non-users were associated with larger differences in moral evaluations.

The researchers concluded that perceptions of effort appear to play a major role in shaping broader social judgement.

The findings support the idea that many people continue to associate moral worth with visible personal struggle and self-discipline, particularly in relation to body weight and weight loss.

“Shortcut” beliefs intensified negative bias

The study also examined factors that influenced the strength of these perceptions.

Participants who held more positive views toward anti-obesity medications, or who had prior personal or social experience with such treatments, tended to judge medication users less harshly.

In contrast, stronger beliefs that anti-obesity medication represents a “shortcut” to weight loss were associated with more negative moral judgements.

In some analyses, these shortcut beliefs also amplified the relationship between perceived effort and bias.

The researchers found that personality traits such as conscientiousness and extraversion had little overall effect on participants’ judgements. This suggests that the bias is driven more by beliefs about effort and treatment legitimacy than by broader personality characteristics.

One exploratory analysis identified a small association with neuroticism, although this effect was limited.

Meta-analytic evidence synthesis across the studies confirmed that most effects were large, particularly for:

• Perceived effort
• Moral judgement
• Competence
• Cooperation satisfaction
• Deservingness

Effects relating to warmth were moderate by comparison.

Findings highlight social challenges surrounding obesity treatment

The researchers concluded that using anti-obesity medication is not simply a medical decision, but also a social one that may expose individuals to stigma and negative judgement.

According to the findings, people using anti-obesity medications are frequently perceived as putting in less effort and are therefore judged as less moral, less competent, and less deserving of success.

Although the studies were based on vignette scenarios rather than real-world interactions, the researchers stated that the findings point toward a widespread bias rooted in effort moralization.

They suggested that these attitudes could influence interpersonal relationships, healthcare experiences, and broader public perceptions of obesity treatment.

The authors argued that addressing these misconceptions is important for improving healthcare quality and reducing obesity-related stigma.

They also suggested that public education and changes in the way weight loss is discussed may help shift attention away from perceived effort and toward health outcomes and overall well-being.

CCH insights:

Unfortunately, this shows that there is still a very poor understanding of obesity amongst the general public, which means that biased, negative attitudes towards people with excess weight persist. Instead of being seen as medical tools to treat a complex chronic condition, GLP-1 medications are seen by many as short-cut for weight loss cheats. Current evidence suggests these attitudes are common even within the health professions. To improve the quality of obesity care, and to encourage those who need help to seek it, these misconceptions must be addressed.

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Carbohydrate-Rich Diets May Promote Weight Gain Even Without Higher Calorie Intake

Key Takeaways: 

• A new mouse study found that carbohydrate-rich foods such as bread, wheat flour, and rice flour promoted weight gain and fat accumulation even when total calorie intake did not significantly increase.
  
• Researchers observed that the weight gain appeared to be linked more closely to reduced energy expenditure and metabolic changes than to overeating.
  
• Scientists say future human studies will explore how factors such as whole grains, fibre content, food processing, meal timing, and combinations with protein and fat influence metabolic responses to carbohydrates.
  
  
  

Bread and carbohydrates under renewed scrutiny

Bread has served as a central part of human diets for centuries and remains a staple food in many cultures around the world. Foods such as bread, rice, noodles, and other carbohydrate-rich staples continue to form the foundation of everyday meals for billions of people.

However, as rates of overweight and obesity continue to increase globally, researchers are re-examining how modern dietary patterns may influence body weight and metabolic health. While high-fat diets have traditionally received much of the attention in obesity research, scientists are now taking a closer look at the role carbohydrates may play in weight regulation.

A new study led by researchers at Osaka Metropolitan University suggests that certain carbohydrate-heavy eating patterns may contribute to weight gain in ways that are not solely explained by consuming more calories.

The findings were published in Molecular Nutrition & Food Research. 

Obesity research has traditionally focused on fat intake

Obesity is associated with a broad range of chronic conditions and lifestyle-related diseases, including type 2 diabetes, cardiovascular disease, and metabolic dysfunction. Because of this, understanding the drivers of weight gain has become an increasingly important area of scientific research.

Historically, many obesity studies have focused primarily on dietary fat as the main contributor to excess weight gain. This is reflected in the widespread use of high-fat diets in animal research investigating obesity and metabolism.

At the same time, carbohydrate-rich foods remain deeply embedded in daily diets across the world. Despite their prominence, the metabolic effects of staple carbohydrates such as bread, rice, and noodles have not always been explored in the same depth.

Public perceptions around carbohydrates also remain widespread. Beliefs such as “bread makes you gain weight” or “carbohydrates should be restricted” are common, yet researchers say it has remained unclear whether such effects are driven by the foods themselves, overall dietary habits, eating behaviour, or broader metabolic responses.

Researchers investigated how carbohydrate-rich foods affect metabolism

To better understand the relationship between carbohydrates and weight gain, researchers led by Professor Shigenobu Matsumura at Osaka Metropolitan University’s Graduate School of Human Life and Ecology conducted a series of experiments in mice.

The study examined whether mice would preferentially select carbohydrate-rich foods over standard laboratory chow and how those dietary choices would affect body weight, metabolism, and energy expenditure.

The mice were separated into several dietary groups, including:

• Chow
• Chow + Bread
• Chow + Wheat Flour
• Chow + Rice Flour
• High-fat diet (HFD) + Chow
• High-fat diet (HFD) + Wheat Flour

Researchers monitored multiple metabolic indicators throughout the study, including:

• Body weight
• Fat mass
• Energy expenditure
• Blood metabolites
• Liver gene activity
  
  
  

Mice preferred carbohydrate-rich foods

The researchers found that mice consistently showed a strong preference for carbohydrate-rich foods. Animals given access to bread, wheat flour, or rice flour largely abandoned their standard chow diet in favour of these carbohydrate sources.

Importantly, the researchers reported that overall calorie intake did not increase substantially despite this dietary shift. Nevertheless, mice consuming the carbohydrate-rich diets still experienced increases in body weight and fat mass.

Rice flour produced similar effects to wheat flour, suggesting the observed metabolic changes were not specific to wheat itself.

Interestingly, mice in the High-fat diet (HFD) + Wheat flour group gained less weight than those in the High-fat diet (HFD) + Chow group, indicating that the interaction between fat and carbohydrate intake may be more complex than previously assumed.

“These findings suggest that weight gain may not be due to wheat-specific effects, but rather to a strong preference for carbohydrates and the associated metabolic changes,” said Professor Matsumura.

Reduced energy expenditure appeared to play a key role

To investigate why the mice gained weight without substantially increasing calorie intake, the researchers carried out further metabolic analysis using indirect calorimetry and respiratory gas measurements.

The findings suggested that the weight gain was not primarily caused by overeating. Instead, the animals appeared to experience reduced energy expenditure, meaning they were burning fewer calories.

Researchers also identified several metabolic changes in the mice consuming the carbohydrate-rich diets.

Blood analysis showed:

• Increased fatty acid levels
• Reduced levels of essential amino acids

Meanwhile, examination of the liver revealed:

• Greater fat accumulation
• Increased activity of genes involved in fatty acid synthesis
• Increased activity of genes associated with lipid transport

Together, these findings suggest that carbohydrate-heavy dietary patterns may alter how the body processes and stores energy.

Metabolic changes improved when carbohydrates were reduced

The researchers also observed that removing wheat flour from the diet rapidly improved both body weight and several metabolic abnormalities.

According to the authors, this finding suggests that moving away from a highly carbohydrate-focused dietary pattern and towards a more balanced eating pattern may help improve metabolic regulation.

However, the researchers emphasised that additional work is needed to determine how these findings translate to human diets and real-world eating behaviour.

Future studies will explore human dietary patterns

The research team says the next phase of investigation will focus on understanding whether similar metabolic effects occur in people.

“Going forward, we plan to shift our research focus to humans to verify the extent to which the metabolic changes identified in this study apply to actual dietary habits,” stated Professor Matsumura.

“We also intend to investigate how factors such as whole grains, unrefined grains, and foods rich in dietary fiber, as well as their combinations with proteins and fats, food processing methods, and timing of consumption, affect metabolic responses to carbohydrate intake. In the future, we hope this will serve as a scientific foundation for achieving a balance between ‘taste’ and ‘health’ in the fields of nutritional guidance, food education, and food development.”

The researchers noted that future studies examining food quality, fibre content, food combinations, and meal timing may help provide a more nuanced understanding of how carbohydrates influence metabolism and body weight.

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