Novo Nordisk’s Oral Semaglutide Shows Cardiovascular Benefits Comparable to Wegovy Injection
Key Takeaways:
- Novo Nordisk’s new oral semaglutide 25 mg pill improved blood glucose control and reduced cardiovascular risk factors, matching the effects of its injectable counterpart, Wegovy.
- Data from the OASIS 4 trial showed significant weight loss and normalisation of blood glucose in people with prediabetes.
- The company expects U.S. regulatory approval for the first oral GLP-1 treatment for weight management by the end of 2025.
Oral GLP-1 pill shows comparable benefits to injection
Novo Nordisk has presented new findings suggesting that its experimental oral obesity medication delivers cardiovascular and metabolic benefits similar to those achieved with its blockbuster injectable, Wegovy. The results were shared at the ObesityWeek 2025 conference in Atlanta and strengthen the Danish company’s case for approval of the pill in the United States later this year.
The oral semaglutide 25 mg tablet, part of the company’s glucagon-like peptide-1 receptor agonist (GLP-1RA) portfolio, was shown to improve blood sugar regulation and reduce cardiovascular risk factors. These results could mark a milestone in obesity care, as the pill would become the first oral GLP-1 therapy approved for weight management.
OASIS 4 trial results
The data come from the OASIS 4 clinical trial, which compared oral semaglutide 25 mg with placebo in adults with overweight or obesity. After 64 weeks, 71.1% of participants with prediabetes who received the treatment achieved normal blood glucose levels, compared with 33.3% in the placebo group.
Participants who lost at least 15% of their body weight experienced additional health benefits, including reductions in blood pressure, inflammatory markers, and triglycerides. Overall, the trial demonstrated both significant weight loss and improvements in cardiometabolic health outcomes.
The primary OASIS 4 results, published in September in the New England Journal of Medicine, reported an average weight loss of 16.6% among participants taking the oral semaglutide.
Comparable outcomes with Wegovy injection
An indirect comparison between OASIS 4 and Novo Nordisk’s earlier STEP 1 trial, which evaluated injectable semaglutide (Wegovy), found the two formulations delivered comparable outcomes in weight reduction and improvements across key cardiometabolic markers.
These findings suggest that people who prefer not to use injectables could soon have an equally effective oral alternative. As demand for obesity pharmacotherapy continues to rise, an oral formulation may further expand access and adherence to GLP-1 treatments.
Regulatory outlook and market plans
The U.S. Food and Drug Administration (FDA) accepted Novo Nordisk’s application for oral Wegovy in May and is expected to deliver a decision by the end of the fourth quarter of 2025. The company has stated that, if approved, it intends to launch the product shortly thereafter.
Despite a recent dip in share price and slower sales growth, Novo Nordisk’s prospects have been buoyed by positive trial outcomes and an improved pricing arrangement under Medicare. The company is also undergoing leadership changes, including a new Chief Executive Officer and a restructured board, amid efforts to stabilise growth.
Novo Nordisk has indicated that, once approved, the pill will be made available through telehealth platforms such as Ro and WeightWatchers, with a potential subscription model offering discounted pricing. Additionally, Hims & Hers Health recently confirmed it is in discussions with Novo to provide both injectable and oral forms of Wegovy through its digital platform.
A step forward in accessible obesity care
If approved, Novo Nordisk’s oral semaglutide could redefine accessibility and adherence in obesity care. The convenience of a pill that matches the efficacy of an injectable treatment offers a compelling new option for people managing obesity and related cardiometabolic risks.
By broadening the range of treatment modalities within the GLP-1 class, Novo Nordisk continues to shape the evolving landscape of obesity pharmacotherapy — a field that is rapidly transforming the management of metabolic health worldwide.
CCH insights
This news about oral semaglutide is very welcome, but shouldn’t come as a surprise. Oral semaglutide is the exact same compound as injectable semaglutide, and as long as the dose administered orally is sufficient to deliver a similar blood concentration as the injectable form, then the effects should be very similar. It’s the same drug, just a cheaper and easier, but less efficient, route of administration.
Read More
Childhood Obesity in England Reaches Highest Level Since Pandemic, New Data Reveal
Key Takeaways:
- One in ten children aged four to five in England are living with obesity, the highest rate since the COVID-19 pandemic.
- Teachers warn that poverty, limited access to nutritious food, and cuts to school sport funding are fuelling the crisis.
- Nearly all teachers agree that healthy eating improves pupil focus, energy, and behaviour, yet many report children arriving at school hungry.
Childhood obesity at record levels outside pandemic years
Newly released data from the National Child Measurement Programme (NCMP) show that 10.5% of children aged four to five (Reception year) in England are living with obesity – the highest prevalence recorded outside of the pandemic period.
The NCMP, which annually measures the height and weight of primary school pupils, also found that more than one in five pupils in Year 6 (aged 10–11) are living with obesity. The findings indicate that boys are more likely to be overweight or obese than girls.
In Reception year, 13% of children were classified as overweight, meaning that almost one in four children in this age group are either overweight or living with obesity.
Excluding the sharp increase seen during the first year of the COVID-19 pandemic, these figures represent the highest obesity prevalence in Reception year since records began in 2006–07 and mark a rise from 9.6% in 2023–24.
Schools feeling the strain
Lee Parkinson MBE, a primary school teacher from Manchester, said that systemic factors and funding cuts have worsened the situation.
“After the 2012 Olympics, school sport funding was cut, and the promise to ‘inspire a generation’ faded fast due to austerity measures,” he explained.
“Many primary schools lost specialist PE teachers and local competitions, and PE time is often squeezed as pressures on the timetable grow. You cannot separate childhood obesity from poverty either.
“Schools play their part through PE and lessons about healthy lifestyles, but they cannot solve this alone. We need to reinvest in early years support, rebuild affordable community sport, and make healthy choices realistic for all families, not just the privileged few.”
The link between nutrition, learning, and behaviour
A related report on children’s nutrition found that 94% of teachers believe healthy eating improves children’s behaviour. Teachers observed that better nutrition had tangible effects on classroom dynamics – with pupils demonstrating sharper focus, more energy, and improved behaviour.
The report underscored that nutritious food at school is not only essential for health and wellbeing but also for learning outcomes.
Hunger and food insecurity
Research from the Trussell Trust highlighted that around 9.3 million people in the UK, including three million children, experience food insecurity. Currently, one in four children under the age of five are at risk of needing to use a food bank.
Mr Parkinson reflected on the impact of poverty on pupils’ concentration: “Obviously with the poverty element, if children are coming into school hungry it will make it harder for them to concentrate.”
This problem is often exacerbated during school holidays, when free school meals are unavailable. Last summer, one in 12 parents reported that their children had to miss meals due to financial difficulties.
Mr Parkinson added: “I do not know if it is lack of knowledge or the fact that unhealthy food is easier to access or what families can afford. When parents are working long hours and struggling to make ends meet, healthy living becomes another impossible task.”
Teachers filling the gap
The majority of teachers (88%) said they had witnessed children arriving at school hungry, with 66% reporting that they had brought in food from home or purchased healthy food for pupils themselves.
Nearly all teachers surveyed (98%) agreed that nutrition forms a vital foundation for learning. However, 83% said it can be challenging to inspire children to make healthy eating choices, particularly when access to nutritious food is inconsistent outside of school.
Measuring the scale
In total, 1.1 million children across state-maintained schools were measured as part of the NCMP data collection for 2024–25.
Public health experts warn that the findings underline an urgent need for coordinated national action to address the intertwined challenges of obesity, poverty, and food insecurity among children in England.
Read More
Thousands in Scotland’s Poorest Areas to Receive Free Weight-Loss Jabs in Landmark Obesity Study
Key Takeaways:
- Up to 5,000 adults living with obesity in Scotland’s most deprived areas will receive free weight-loss injections through the new Scotland CardioMetabolic Impact Study (SCoMIS).
- The multi-million-pound research, led by the University of Glasgow, aims to test the real-world delivery and impact of incretin-based therapies in NHS care.
- The study seeks to reduce health inequalities, improve quality of life, and lessen the long-term burden of obesity on individuals and the NHS.
Landmark initiative targets obesity in Scotland’s most deprived communities
Thousands of people from some of Scotland’s most economically deprived areas will soon be offered free weight-loss injections as part of a major UK government-funded study. The initiative, known as the Scotland CardioMetabolic Impact Study (SCoMIS), will recruit between 3,000 and 5,000 participants living with obesity to test how new weight-loss medicines can be delivered effectively and fairly in everyday NHS care.
The research is being led by the University of Glasgow and is backed by an initial £650,000 in funding from the UK government. If successful, it could pave the way for a wider rollout of the medicines across the country, offering a model for addressing both obesity and health inequality.
How the jabs work
The injections mimic or enhance the effects of naturally occurring hormones called incretins, which help control blood sugar levels. These hormones act on areas of the brain that regulate hunger and appetite and can also slow down how quickly the stomach empties. Together, these effects may support people living with obesity to better manage their eating habits and achieve sustained weight loss.
A national effort to reduce health inequality
Dr Zubir Ahmed, UK Health Innovation Minister, said:
“As a practising NHS surgeon and Glasgow MP, I know firsthand the impact of the obesity crisis that plagues Scotland – and the litany of health problems it leads to. More than 1 in 3 adults in Scotland’s most deprived areas are living with obesity. The UK government is committed to tackling inequality wherever it finds it in our country. It’s why this landmark UK government investment is targeting help where it’s needed most in Scotland and meeting people where they are and backing helping the NHS services they trust to treat them.”
Obesity is one of the leading contributors to long-term illness, including heart disease, type 2 diabetes, and several cancers. By addressing obesity through targeted intervention, the UK government hopes to help millions live longer, healthier lives while reducing the strain on the NHS and saving billions in healthcare costs each year.
Study objectives
The SCoMIS trial will evaluate several key areas of impact:
- Delivery: How weight-loss medicines can be integrated into everyday NHS care, especially within community and primary care settings.
- Outcomes: The degree of weight loss achieved and improvements in quality of life, particularly among people from disadvantaged areas.
- Health impact: The effects on obesity-related conditions, NHS service use, and healthcare expenditure.
- Social benefits: Whether improved health through weight loss can help individuals remain in work, reduce sick leave, and participate more fully in society.
Leading experts and national collaboration
Professor Jason Gill, Professor of Cardiometabolic Health at the University of Glasgow and the lead investigator, said:
“While tackling obesity requires multifactorial public health action, incretin therapies add a powerful new tool to the national obesity strategy. The burden of obesity is greatest in the most deprived segments of society and the status quo risks widening health inequalities. SCoMIS aims to be a landmark real-world study evaluating a new model of obesity care, providing incretin treatment via primary and community care to Scottish adults living with obesity, with a focus on those in the most economically deprived communities.”
The project is being developed in collaboration with the Universities of Dundee and Edinburgh, industry partners Novo Nordisk and IQVIA, and clinical leaders across Scotland. The consortium will also explore how AI-driven digital technologies can improve patient access, engagement, and data collection throughout the study.
Supporting innovation and evidence-based care
Jenni Minto, Scottish Minister for Public Health, highlighted Scotland’s leadership in advancing obesity research:
“This study places patients and communities at the heart of cutting-edge research into weight-loss medicines, ensuring we build the evidence needed to deliver the greatest benefit to those who need it most.”
UK Science Minister Lord Vallance also praised Scotland’s role in global medical innovation:
“Scotland has always been at the forefront of medical innovation and public health, and this initiative is further proof of the world-class expertise that can be found here. By learning how these weight-loss medicines work, and how we can support them to reach our most deprived areas, we can slash health inequalities in Scotland and the rest of the UK so that our obesity strategy delivers a real, lasting change.”
Looking ahead
Set to launch next year, the SCoMIS study represents one of the most ambitious real-world obesity trials in the UK to date. Its outcomes are expected to shape future national strategies on obesity care, providing a template for equitable access to advanced weight-loss treatments and supporting a healthier, more inclusive society.
CCH insights
This study is very much welcomed, although arguably long overdue. Obesity and associated diseases, most notably type 2 diabetes and cardiovascular disease, are most prevalent in communities with high levels of deprivation, and are a huge cost to the NHS. People in these communities living with obesity should be prioritised in terms for GLP-1 therapy, as this should help to drive down health inequalities and provide massive future financial savings for the health service.
Read More
GLP-1 Weight Loss Drugs Linked to First National Decline in Obesity Rates, Survey Finds
Key Takeaways:
- The U.S. adult obesity rate has dropped from 39.9% to 37% over three years, coinciding with a rapid rise in GLP-1 medication use.
- Over 12% of adults now report taking injectable obesity drugs such as semaglutide or tirzepatide, more than double the proportion from early 2024.
- Experts warn that limited insurance coverage may soon hinder access, potentially reversing progress.
New survey suggests decline in U.S. obesity rates
The proportion of adults living with obesity in the United States has declined for the first time in years, according to a new Gallup National Health and Well-Being Index survey. The findings suggest that the surge in the use of injectable obesity drugs may be driving this shift.
The survey reported that 37% of U.S. adults are currently living with obesity, compared with a peak of 39.9% three years ago. Researchers attribute much of this reduction to the growing uptake of GLP-1 receptor agonists, a class of highly effective weight loss drugs that include semaglutide and tirzepatide.
Use of GLP-1 medications has more than doubled
The number of people using GLP-1-based treatments such as Ozempic and Wegovy (semaglutide), or Zepbound and Mounjaro (tirzepatide), has more than doubled over the past 18 months. According to Gallup, 12.4% of respondents reported using these drugs, up from 5.8% in February 2024, when the organisation first began tracking their use.
GLP-1 receptor agonists, which mimic a naturally occurring hormone that regulates appetite and blood sugar, were first approved for obesity treatment in 2021. Their mechanism of action involves acting on the brain and gut hormones to suppress hunger and slow digestion, helping individuals sustain weight loss.
A watershed in obesity treatment
Experts consider the introduction of GLP-1 receptor agonists to be a landmark in obesity treatment, following decades of limited progress through diet, exercise, and public health campaigns.
Gallup described the new generation of GLP-1 drugs as a “watershed in Americans’ long struggle to address obesity and related diseases.” Despite these advances, the survey also found that diabetes rates have reached a record high: 13.8% of adults reported having been diagnosed by a doctor or nurse. This highlights the scale of ongoing metabolic health challenges even as weight loss interventions improve.
Impact seen most among middle-aged adults and women
The data indicate that the reduction in obesity rates has been most notable among adults aged 40 to 64, a demographic more likely to use GLP-1 medications. Among those aged 50 to 64, obesity prevalence fell by 5.0 percentage points, reaching 42.8%.
The survey also noted differences by sex: women were more likely than men to use these medications and tended to report greater weight loss benefits. This aligns with previous clinical research showing that women are often more proactive in seeking medical support for weight management.
Access and affordability remain key challenges
Despite their effectiveness, access to GLP-1 drugs remains uneven and may worsen in the coming year. Dr Fatima Cody Stanford, an obesity specialist at Harvard University, cautioned that while the correlation between increased access and reduced obesity rates is promising, it may not be sustainable if coverage declines.
“I would say this correlation happened for those that had great coverage, but it’s going to be pulled back,” she said.
Dr Stanford explained that several private insurers – including those covering most of her patients – are planning to stop covering GLP-1 medications as of next year. Without insurance, the cost of injections typically reaches around $500 per month out of pocket, she noted.
Although pharmaceutical companies are developing oral versions that may eventually reduce costs, Dr Stanford warned that these treatments will likely remain unaffordable for many in the short term.
“While drugmakers are working to bring potentially less-expensive pill versions to market, it likely still will put the treatments out of reach for many,” she said.
Slow but significant progress
While the findings do not confirm causation, they offer one of the first indications that the widespread use of GLP-1 receptor agonists could be contributing to measurable declines in obesity prevalence. Public health experts stress, however, that long-term trends will depend heavily on sustained access, equitable prescribing, and broader changes in lifestyle and preventive care.
For now, the data mark a tentative but meaningful turning point in the decades-long fight against obesity in the United States – a shift that could influence obesity strategies worldwide if sustained.
Read More
Age and Sex Shape Obesity’s Impact on Major Diseases, Large Genetic Study Finds
Key Takeaways:
- A time-resolved genetic analysis of over 360,000 UK Biobank participants shows that obesity’s health risks vary substantially across age and between men and women.
- Higher BMI was causally linked to greater risk of type 2 diabetes, coronary artery disease, atrial fibrillation, and osteoarthritis, but the timing and intensity of these effects differed by condition.
- The study’s novel genetic approach revealed that preventive interventions such as statin or blood pressure treatment may temporarily dampen obesity-related cardiovascular risk in midlife.
Understanding obesity’s changing health risks
Nearly one billion adults globally live with obesity, making it a key driver of type 2 diabetes (T2DM), coronary artery disease (CAD), atrial fibrillation (AF), and osteoarthritis (OA). Yet researchers have long struggled to pinpoint when in life excess body weight does the most harm.
Most studies average risk across all adults, masking crucial age-specific patterns. Body mass index (BMI) remains the standard measure of obesity, but its health impact may shift as metabolism, hormones, behaviour, and medical care evolve through life. Moreover, traditional epidemiological studies cannot always distinguish correlation from causation.
Genetic studies using Mendelian randomisation (MR) can infer causal effects, but conventional MR assumes that risks remain constant over time. In a new paper published in Science Advances, researchers introduced a time-resolved MR framework that tracks how obesity’s effects on major diseases change with age and differ between sexes.
Study design and methods
The researchers analysed data from 361,906 unrelated adults of European ancestry within the UK Biobank, a large population-based health resource. Participants had linked genetic and medical record data, and follow-up continued until a median age of around 70 years, capped at 76 to avoid sparse data at older ages.
BMI at study entry was standardised within sex-by-age groups. The primary outcomes were first occurrences of T2DM, CAD, AF, and OA, identified using International Classification of Diseases (ICD-10) codes.
To establish causal relationships, the team employed MR using polygenic scores (PGS) as instruments. They performed genome-wide association studies (GWAS) for BMI in two independent subsamples (each ~180,953 participants) to identify genome-wide significant genetic variants.
To minimise reverse causation, disease-specific BMI PGS were filtered using the Steiger method, which excluded variants that explained more variation in disease outcomes than in BMI itself. The researchers then modelled time-to-event data using Aalen’s additive hazard model, estimating both cumulative (“life-course”) and age-specific (“momentary”) effects.
Sensitivity analyses accounted for potential biases, including lipid-lowering treatment among CAD-free participants, blood pressure (SBP) as an alternative exposure, and cohort selection effects.
Distinct patterns across diseases
Across adulthood, higher BMI was causally associated with increased rates of all four conditions, but with striking differences in timing and trajectory.
- Osteoarthritis (OA): BMI-related risk rose early in life, becoming significant over 20 years before risk for AF increased. This suggests that musculoskeletal strain and inflammatory pathways linked to obesity manifest relatively early.
- Atrial Fibrillation (AF): The risk associated with BMI intensified later in adulthood, suggesting that atrial and metabolic factors accumulate over time.
- Type 2 Diabetes (T2DM): The effect of BMI increased steadily from midlife but plateaued between ages 60 and 70, indicating that preventive measures or clinical interventions may mitigate risk during this period.
- Coronary Artery Disease (CAD): The most distinctive pattern emerged here – a U-shaped curve. Risk decreased markedly around ages 50 to 70 before rising again in older age. This midlife dip was not explained by study participation patterns but appeared more pronounced among individuals on lipid-lowering medication such as statins, suggesting that treatment may blunt BMI-related cardiovascular risk during this window.
When the researchers replaced BMI with systolic blood pressure (SBP) as the exposure, AF risk displayed a similar midlife trough, consistent with the effect of antihypertensive therapy. However, no comparable trough appeared for CAD, reinforcing the role of statins rather than blood pressure control in midlife coronary risk reduction.
Sex differences in risk
Sex-stratified analyses revealed generally stronger BMI effects in men for T2DM, CAD, and AF. Osteoarthritis was an exception: both sexes exhibited similar BMI-related risk until about age 60, after which the association appeared to decline slightly in women, although the results carried uncertainty due to diverging confidence intervals.
A particularly notable finding concerned T2DM. Women displayed a distinct, temporary reduction in BMI-related diabetes risk beginning around age 60 and lasting roughly a decade, whereas men’s risk continued to rise. This “female trough” was not accounted for by menopause timing or the use of hormone therapy, suggesting that behavioural or clinical factors – such as greater engagement with weight management or preventive health care – could play a role.
Genetic and methodological insights
Clustering of BMI-associated genetic variants revealed multiple mechanistic pathways underlying obesity’s effects. Different genetic clusters contributed distinct temporal risk patterns for CAD and T2DM. For instance, “high-risk” clusters largely accounted for the CAD trough and the sex differences seen in T2DM.
Importantly, the researchers verified that the strength of genetic effects on BMI declines with age, underscoring the need for age-sensitive models. Simulation studies confirmed that their time-resolved MR method accurately captured dynamic effects even when the genetic influence on BMI varied over time.
Adjustments for potential selection bias slightly reduced the overall magnitude of effects but preserved key age-related patterns, including the midlife risk reductions.
Clinical implications
The findings emphasise that the timing of prevention matters as much as the magnitude of obesity itself. Sustained high BMI elevates the risk for several major diseases, but the most effective period for intervention differs by condition and by sex.
For example:
- Lipid-lowering treatment in midlife may attenuate BMI-related CAD risk.
- Blood pressure control could moderate AF risk later in life.
- Women may experience a unique window in their 60s when obesity-related diabetes risk temporarily subsides.
The authors conclude that prevention strategies should be tailored to life stage and sex, targeting the periods when intervention can avert the greatest number of disease events.
They also note limitations, including the assumption of an immediate biological response to BMI changes and the reduced precision of genetic instruments for early-life BMI. Nonetheless, their time-resolved MR framework offers a powerful new approach for uncovering dynamic, age-specific health risks that static analyses may obscure.
Read More
Semaglutide’s Cardioprotective Effects Extend Beyond Weight Loss, SELECT Trial Confirms
Key Takeaways:
- Semaglutide significantly reduced major adverse cardiovascular events (MACE) in adults with overweight or obesity and established cardiovascular disease, regardless of baseline body weight.
- Reductions in waist circumference contributed partly – but not fully – to the observed cardioprotective benefits, suggesting mechanisms beyond weight loss.
- Early divergence in cardiovascular outcomes between the semaglutide and placebo groups indicates that benefits emerge rapidly after treatment initiation.
Semaglutide’s impact on heart health goes beyond weight loss
A landmark study published in The Lancet has revealed that semaglutide, a Glucagon-Like Peptide 1 Receptor Agonist (GLP-1RA), offers cardiovascular protection in people with overweight and obesity that cannot be explained by weight loss alone. The findings come from the large-scale SELECT trial, which explored the drug’s effect on major adverse cardiovascular events (MACE) in individuals without diabetes but with established cardiovascular disease.
GLP-1 receptor agonists were originally developed for glycaemic control in type 2 diabetes but have since demonstrated additional benefits, including weight reduction and decreased cardiovascular risk. Obesity itself increases cardiovascular mortality and morbidity through metabolic, inflammatory, and haemodynamic pathways. However, simple measures such as body weight fail to differentiate between fat and lean mass or between subcutaneous and visceral fat – the latter being more strongly associated with cardiovascular disease.
Until now, the relationship between changes in adiposity induced by GLP-1RAs and subsequent cardiovascular outcomes has remained unclear.
About the SELECT trial
The SELECT trial was a randomised, double-blind, placebo-controlled, phase 3 study evaluating whether semaglutide, used alongside standard care, could reduce cardiovascular events in adults with overweight or obesity. The trial enrolled 17,604 participants aged 45 years or older with a body mass index (BMI) of at least 27 kg/m² and established cardiovascular disease (defined as a history of myocardial infarction, stroke, or symptomatic peripheral artery disease).
Participants were randomly assigned to receive either once-weekly semaglutide injections or a placebo, with a gradual 16-week dose escalation to a target of 2.4 mg from week 17 onwards. The primary endpoint was MACE – a composite measure including non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death.
Researchers analysed both baseline measures of adiposity (including waist circumference and body weight) and treatment-induced changes over time. Associations between these factors and MACE were assessed using a Cox proportional hazards model, with additional analyses distinguishing early (week 20) and long-term (week 104) effects.
Key findings
The mean follow-up period was nearly 40 months, with participants exposed to semaglutide for an average of 33.3 months and placebo for 35.1 months. Across all baseline body habitus measures, semaglutide reduced MACE incidence compared with placebo.
Higher baseline BMI was associated with female sex, younger age, non-Asian nationality, higher blood pressure, prediabetes, and greater inflammatory burden. Within both study arms, individuals with lower baseline adiposity had a lower MACE risk. In the semaglutide group, MACE risk fell by approximately 4% for every 5 kg reduction in baseline weight, although this trend was not significant in the placebo group. For waist circumference, both groups showed a 4% lower risk per 5 cm smaller baseline measurement.
By week 20, the rate of first MACE events had already diverged between the groups (hazard ratio [HR] 0.58), demonstrating an early cardioprotective effect.
At this point, mean changes in body weight and waist circumference were −6.4% and −5.0 cm in the semaglutide group, compared with −0.8% and −1.1 cm in the placebo group. These early changes accounted for about 70% of the total reductions seen at week 104. Importantly, 11% of all MACE events occurred within the first 20 weeks of treatment.
In the semaglutide group, greater reductions in waist circumference were associated with a lower subsequent MACE risk (HR 0.91; 95% CI 0.84–0.98; p = 0.02), while weight loss alone was not linearly linked to reduced risk. Among placebo recipients, those who lost at least 5% of their weight experienced higher MACE incidence and all-cause mortality, possibly reflecting unintentional or illness-related weight loss.
At week 104, semaglutide recipients who achieved the greatest weight loss had the lowest MACE incidence, whereas placebo recipients with comparable weight loss had the highest.
Waist circumference emerged as a stronger predictor
Analyses indicated that waist circumference reduction was a partial mediator of semaglutide’s cardiovascular benefits. Accounting for early changes in waist circumference reduced the treatment hazard ratio from 0.80 to 0.86 – suggesting that about one-third (33%) of the cardioprotective effect could be attributed to reduced abdominal fat, while the remainder likely involves other physiological mechanisms.
Crucially, time-varying changes in overall weight did not mediate the observed cardiovascular outcomes, underscoring that semaglutide’s heart-protective properties extend beyond simple weight loss.
Implications and limitations
The authors concluded that semaglutide was superior to placebo in reducing cardiovascular risk across all baseline weight and waist circumference levels, and that its benefits became evident early in treatment. They emphasised that early body weight reductions did not independently explain these benefits.
They cautioned, however, that analyses performed after randomisation were exploratory and not causal. The predominantly White, male study population also limits generalisability to broader groups, including women and ethnically diverse populations.
Despite these caveats, the findings strengthen the evidence that semaglutide’s cardioprotective effects go beyond adiposity reduction, pointing to additional metabolic, vascular, or anti-inflammatory mechanisms.
The SELECT trial was funded by Novo Nordisk, and is registered under ClinicalTrials.gov identifier NCT03574597.
Read More
Obesity-Linked Lipids Drive Aggressive Breast Cancer Growth in Mouse Models
Key Takeaways:
- New research from the University of Utah reveals that lipids – fat molecules elevated in people living with obesity – can accelerate tumour growth in aggressive forms of breast cancer.
- The findings suggest that lipid-lowering therapies may slow cancer progression and that high-fat diets such as ketogenic regimens may worsen outcomes in some patients.
- Researchers caution that weight loss without addressing lipid levels is insufficient protection against obesity-associated cancers like triple-negative breast cancer.
Lipids identified as key driver in obesity-related breast cancer
A new study from the University of Utah’s Huntsman Cancer Institute (HCI) has found that lipids, a hallmark of obesity, play a significant role in fuelling tumour growth in an aggressive form of breast cancer. The research, funded by the National Cancer Institute and conducted using preclinical mouse models, highlights how lipid metabolism may be a crucial therapeutic target for individuals living with obesity who have or have survived breast cancer.
The findings suggest that breast cancer patients and survivors with obesity could benefit from therapies that lower lipid levels. Conversely, high-fat dietary approaches, such as the ketogenic diet, may have unintended adverse effects by increasing lipid availability to cancer cells.
“The key here is that people have underestimated the importance of fats and lipids in the all-encompassing term that is obesity,” explained Dr Keren Hilgendorf, assistant professor of biochemistry and investigator at HCI. “But our study shows that breast cancer cells are really addicted to lipids, and the abundance of lipids in patients with obesity is one of the reasons that breast cancer is more prevalent and more aggressive in these patients.”
Focus on triple-negative breast cancer
The study focused on triple-negative breast cancer (TNBC) – a fast-growing and difficult-to-treat subtype that lacks receptors for oestrogen, progesterone, and HER2. TNBC is more common in women under 40 and in Black women, and it accounts for approximately 10 to 15 per cent of all breast cancer cases. This form of cancer is particularly prone to recurrence and metastasis.
A high level of lipids in the blood, known as hyperlipidaemia, is a frequent feature of obesity. Dr Hilgendorf and her colleagues, Dr Amandine Chaix and Dr Greg Ducker, both from HCI, examined how lipid levels influence tumour growth using specialised mouse models.
Lipid levels alone drive tumour growth
The researchers used two sets of models: one group of mice was fed high-fat diets, while another was genetically engineered to develop hyperlipidaemia without other typical markers of obesity, such as elevated blood glucose or insulin levels. In both cases, tumours grew faster when lipid levels were high.
“The idea is that lipids, which form the surface membrane of the cell, are like building blocks,” explained Dr Chaix, assistant professor of nutrition and integrative physiology. “If a cell receives the signal to proliferate and more building blocks are available, the tumour is going to grow more easily. We see that a high amount of lipids enables this proliferation.”
Importantly, when lipid levels were lowered – even in the presence of high glucose and insulin – breast cancer cell growth slowed down.
Potential implications for treatment and prevention
While the research was conducted in mice, the results point to potential therapeutic strategies for people with obesity and breast cancer.
“We think this has therapeutic implications, because if you could just lower the lipids – which we already know how to do in patients, for example, with lipid-lowering medication – that could be a way to decelerate breast cancer growth,” said Dr Hilgendorf. “If we can target these high levels of fat in the blood, the cancer sufferers, because the lipids are no longer feeding the cancer. But while our results in mice were striking, there are clear limitations in directly projecting these findings onto human patients. More research using human samples and patients will be necessary to confirm our hypotheses.”
Rethinking weight management in cancer care
These findings may also influence how clinicians guide people with obesity and breast cancer in managing their weight. While weight loss is commonly recommended to reduce recurrence risk, there is limited guidance on the best dietary approaches.
Some individuals turn to ketogenic diets, which are high in fat and low in carbohydrates, to induce ketosis – a state where the body uses fat rather than carbohydrates for energy. However, the new findings raise concerns about such diets in this patient group.
“For patients who are diagnosed with breast cancer and have an elevated BMI [body mass index], we would advise them to consult their physician and develop a weight-loss plan as part of their treatment,” said Dr Ducker, assistant professor of biochemistry. “If you have high cholesterol levels to start with, think about a weight-loss plan or potential pharmaceuticals that could lower your lipid levels. As our study shows, diets like keto that are very high in fat can have serious unintended side effects – even causing the tumour to grow.”
Beyond breast cancer: Broader implications
The research team believes that lipid-driven tumour growth may not be limited to breast cancer alone. Elevated lipid levels could also contribute to tumour progression in other cancers linked to obesity, such as ovarian or colorectal cancers.
The next stage of the research will investigate how anti-lipid drugs could improve the effectiveness of chemotherapy and explore the mechanisms through which lipids feed cancer cells.
Dr Chaix, Dr Ducker and Dr Hilgendorf emphasised that their results apply specifically to triple-negative breast cancer, and that ketogenic diets might still hold benefits for other forms of cancer. Nevertheless, their findings underscore the need for careful, evidence-based dietary guidance for people with obesity affected by cancer.
Read More
AI Model Could One Day Help Prevent Childhood Obesity by Counting Bites
Key Takeaways:
- Researchers at Penn State have developed an artificial intelligence (AI) system capable of counting how many bites a child takes during a meal, achieving around 70% accuracy compared to human observers.
- Eating too quickly increases the risk of obesity in children because the body has less time to register fullness, leading to overeating.
- The AI system, named ByteTrack, may in future help parents, clinicians, and researchers monitor and guide children’s eating habits in real-world environments.
AI and eating behaviours: A new frontier in obesity prevention
The faster a child eats, the greater their risk of developing obesity, according to researchers from the Penn State Department of Nutritional Sciences. However, accurately measuring bite rate—the number of bites taken during a meal—has long posed a challenge. Traditionally, this requires a researcher to watch and manually record each bite from hours of video footage, limiting most studies to small, controlled laboratory environments.
In a collaborative effort between Penn State’s Departments of Nutritional Sciences and Human Development and Family Studies, researchers have created an AI model designed to automate this process. Their pilot study, published in Frontiers in Nutrition, shows that the system is currently around 70% as effective as a human observer in counting bites. Although still under development, the researchers believe the technology could eventually help identify when a child needs to slow their eating rate or adjust their eating behaviour.
The link between eating speed and obesity
“When we eat quickly, we do not give our digestive tract time to sense the calories,” explained Professor Kathleen Keller, the Helen A. Guthrie Chair of Nutritional Sciences at Penn State and co-author of the study. “The faster you eat, the faster it goes through your stomach, and the body cannot release hormones in time to let you know you are full. Later, you may feel like you have overeaten, but when this behaviour repeats, faster eaters are at greater risk for developing obesity.”
Keller’s research group has previously demonstrated that a faster bite rate, especially when combined with larger bite size, correlates with a higher likelihood of obesity in children. Other studies have also linked larger bite size to an increased risk of choking.
“Bite rate is often the target behaviour for interventions aimed at slowing eating rate,” noted Dr Alaina Pearce, research data management librarian at Penn State and co-author of the study. “This is because bite rate is a stable characteristic of children’s eating style that can be targeted to reduce their eating rate, intake, and ultimately risk for obesity.”
Manually recording bite rate, however, is both labour-intensive and costly. As Keller pointed out, “Measuring bite rate is tedious, labour-intensive work, meaning it is expensive, which often limits the amount of data considered in bite rate studies.”
Using AI to support healthier habits
To overcome these limitations, Yashaswini Bhat, a doctoral candidate in nutritional sciences and lead author of the study, set out to develop the first AI-powered bite counter designed specifically for studying children’s eating behaviours.
“I have an interest in AI and data science, but I had never developed a system like this one,” Bhat explained.
She partnered with Associate Professor Timothy Brick, from Penn State’s Department of Human Development and Family Studies, to create a system capable of detecting children’s faces within videos and identifying when a child takes a bite.
“An experienced and knowledgeable collaborator like Dr Brick was invaluable to this project,” Bhat added.
The team trained the system using 1,440 minutes of video footage from Keller’s Food and Brain Study, funded by the National Institute of Diabetes and Digestive and Kidney Diseases. The footage featured 94 children aged seven to nine, each consuming four meals with identical foods on different occasions.
Researchers manually identified bites in 242 videos to train the AI. Once the system had been trained to recognise what a bite looks like, it was tested on an additional 51 videos. The AI’s results were then compared to those of human researchers.
Promising early results
“The system we developed was very successful at identifying the children’s faces,” Bhat said. “It also did an excellent job identifying bites when it had a clear, unobstructed view of a child’s face.”
While the AI was 97% as effective as a human observer at recognising faces, it achieved about 70% accuracy in counting bites. Bhat noted that challenges arose when children were partially obscured, turned away from the camera, or engaged in behaviours such as chewing on their spoons or playing with their food—actions common among younger participants.
“The system was less accurate when a child’s face was not in full view of the camera or when a child chewed on their spoon or played with their food, as often happens toward the end of a meal,” Bhat said. “Chewing on a utensil sometimes appeared to be a bite, and this complicated the task for the AI model.”
Next steps for the ByteTrack system
Although still in its early stages, the researchers view the pilot as an important step toward automating bite rate analysis. The system, called ByteTrack, will continue to be refined so it can distinguish between bites and similar movements such as sipping a drink.
“The eventual goal is to develop a robust system that can function in the real world,” Bhat said. “One day, we might be able to offer a smartphone app that warns children when they need to slow their eating so they can develop healthy habits that last a lifetime.”
The research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, the National Institute of General Medical Sciences, the Penn State Institute for Computational and Data Sciences, and the Penn State Clinical and Translational Science Institute.
Read More
Italy Officially Recognises Obesity as a Chronic Disease under New Law
Key Takeaways:
- Italy becomes the first country to officially recognise obesity as a chronic, progressive, and relapsing disease under national law.
- The new legislation ensures access to prevention, early diagnosis, and treatment through the National Health Service, supported by dedicated funding and professional training.
- The law marks a cultural and clinical milestone, combating stigma and embedding obesity care into multidisciplinary health and social policies.
A landmark in public health policy
Italy has taken a historic step forward in the recognition and treatment of obesity. Following final approval in the Senate, a new law formally recognises obesity as a chronic, progressive, and relapsing disease, fully incorporated within the National Health Service (Servizio Sanitario Nazionale, SSN). This recognition places obesity among the conditions requiring prevention, early diagnosis, and integrated care, marking a fundamental shift in how the nation addresses one of its most pervasive health challenges.
Until now, obesity—despite its well-documented health, social, and economic burden—was often perceived as an “individual problem” tied to lifestyle choices and personal responsibility. This new law redefines that narrative. It positions obesity as a medical condition requiring structured clinical and social support, thereby recognising the biological, psychological, and environmental factors that contribute to it.
Leadership and legislative consensus
The legislation was spearheaded by Hon. Roberto Pella, President of the Interparliamentary Group on Obesity, Diabetes and Non-Communicable Diseases (NCDs), who has long advocated for stronger prevention policies, enhanced patient rights, and healthier urban environments.
The final version of the bill approved by the Senate mirrors that previously passed by the Chamber of Deputies, reflecting broad cross-party agreement on the urgent need to address obesity as a national health priority.
Key provisions of the law
The new law introduces a comprehensive framework of measures that address obesity through prevention, treatment, research, and social inclusion.
- Access to Essential Levels of Care (LEA): People living with obesity will now have guaranteed access to diagnostic and therapeutic services under the National Health Service, ensuring equitable treatment and continuity of care.
- National Programme for Prevention and Care: Dedicated funding will progressively increase from €700,000 in 2025, to €800,000 in 2026, and €1.2 million annually from 2027 onwards. These resources will support prevention campaigns, public awareness efforts, anti-stigma initiatives, and projects promoting social inclusion.
- Health Promotion: The law prioritises preventive health measures, including nutrition education in schools, support for breastfeeding, and programmes encouraging regular physical activity across all age groups.
- Social Inclusion: New provisions promote the full participation of people living with obesity in society—whether in the workplace, education, or recreation—by addressing structural barriers and discrimination.
- Training for Health Professionals: From 2025, €400,000 annually will be invested in training doctors, paediatricians, psychologists, and other healthcare professionals to improve clinical understanding of obesity and strengthen multidisciplinary care.
- National Observatory for the Study of Obesity (OSO): A new Observatory will be established within the Ministry of Health to oversee the implementation of the law. It will monitor outcomes, coordinate research, and present an annual report to Parliament, ensuring transparency and accountability.
- Awareness Campaigns: A permanent fund of €100,000 per year will support public initiatives promoting balanced nutrition and physical activity. Schools, pharmacies, physicians, and local authorities will play key roles in these campaigns.
Cultural and clinical significance
The adoption of this law represents a dual victory—both cultural and medical. Culturally, it challenges the long-standing stereotypes and stigma that have surrounded obesity, reframing it as a health condition rather than a personal failing. It acknowledges the dignity and rights of people living with obesity and underscores the need for inclusion and respect in both healthcare and everyday life.
Clinically, the law ensures equal access to prevention and treatment and formally integrates obesity into structured healthcare pathways. This institutional recognition paves the way for better coordination between medical professionals, community services, and social care systems.
A multidisciplinary and cross-sectoral approach
The reform promotes a multidisciplinary model of care, encompassing prevention, education, inclusion, and research. It also aligns obesity management with broader public health objectives, connecting healthcare policy with urban planning, education, and sport.
By mandating ongoing monitoring through the National Observatory and annual parliamentary reporting, the law ensures a strong framework for governance and sustained progress.
Towards broader change
As Hon. Roberto Pella’s leadership demonstrates, this legislation is not merely a symbolic step—it establishes a concrete foundation for long-term change. The next phase will involve implementing its provisions effectively, strengthening local prevention programmes, supporting patient associations, and fostering partnerships between healthcare providers, schools, and community organisations.
Obesity is not only a disease but also a reflection of how societies live, eat, and structure their environments. Italy’s new law acknowledges this complexity. It is a decisive move toward compassion, inclusion, and evidence-based care, ensuring that people living with obesity receive the attention, respect, and medical support they deserve.
Read More
Precision Medicine Poised to Redefine Obesity Prevention and Treatment
Key Takeaways:
- Researchers at the Pennington Biomedical Research Center highlight how precision medicine could revolutionise the prevention, diagnosis, and treatment of obesity by tailoring interventions to an individual’s biology and environment.
- Significant barriers remain, including limited large-scale clinical trials, underrepresentation of diverse populations, and challenges in integrating personalised tools into clinical practice.
- Experts call for robust biomarkers, inclusive research, and policy support to make precision obesity care accessible and evidence-based.
A blueprint for personalised obesity care
A new report led by researchers at the Pennington Biomedical Research Center underscores the rapidly growing potential of precision medicine to transform how obesity is prevented, diagnosed, and treated. Published in Obesity in September, the paper titled “Precision Prevention, Diagnostics and Treatment of Obesity” brings together insights from the recent Pennington–Louisiana Nutrition Obesity Research Center (NORC) scientific workshop.
The workshop, held in April 2024, convened experts to review evidence on tailoring obesity interventions to a person’s unique biological, behavioural, environmental, and social characteristics. The resulting report presents both the opportunities and obstacles in implementing precision-based strategies in obesity care.
Understanding the multifactorial nature of obesity
The authors emphasise that obesity is not a one-size-fits-all condition. Instead, it is shaped by a complex interplay of factors including genetics, epigenetics, metabolic phenotypes, microbiome composition, and environmental exposures. These elements influence why individuals gain or lose weight differently and why some respond better to certain interventions than others.
The review highlights how understanding these factors could enable clinicians to identify subgroups of people with obesity who would benefit from specific preventive or therapeutic strategies. This approach marks a shift from broad public health recommendations towards tailored, data-driven care.
Diagnostic innovation: Towards greater precision
The report calls for improved diagnostic tools—including the development of reliable biomarkers, imaging technologies, and phenotypic classifications—to better characterise the different subtypes of obesity and related risk profiles.
By accurately identifying an individual’s obesity phenotype, clinicians may be able to predict treatment response more effectively and target interventions that align with a person’s unique biology and lifestyle. Such advances could help move beyond the current trial-and-error approach in weight management.
Treatment personalisation and the path ahead
Emerging research indicates that personalising diet, physical activity, pharmacotherapy, and behavioural interventions according to an individual’s biological and psychosocial characteristics may improve both efficacy and long-term sustainability of outcomes.
However, the authors caution that while enthusiasm for precision-based treatment is growing, more robust clinical evidence is essential before these approaches can be fully integrated into standard care.
“Despite tremendous interest in precision-based treatment, the field is still relatively young,” said Dr Corby Martin, Co-Chair of the symposium and Director of the NORC Human Phenotyping Core. “We need rigorous clinical trials to empirically determine if precision treatment is indeed better than current practices. Unfortunately, few such trials exist, and those that do are not always supportive.”
Persistent gaps and barriers
The report identifies several key challenges hindering progress in precision obesity medicine:
- Limited large-scale clinical trials validating precision approaches.
- Insufficient diversity in study populations, leading to reduced generalisability of findings.
- Inadequate cost-effectiveness data, making implementation difficult within healthcare systems.
- Integration challenges when introducing precision tools into routine clinical settings.
Addressing these barriers will be essential for translating the promise of precision medicine into meaningful clinical and public health outcomes.
Recommendations for future research and policy
To advance the field, the authors recommend:
- Conducting diverse and inclusive research to ensure results are representative across ethnicities, genders, and socioeconomic groups.
- Developing and validating robust biomarkers and imaging tools for more accurate diagnosis and monitoring.
- Running comparative effectiveness trials to determine whether precision interventions outperform current standard treatments.
- Implementing programmes and policies that make precision obesity care both accessible and affordable.
The report suggests that precision-based approaches could enhance obesity prevention by identifying people at risk earlier and tailoring lifestyle or environmental interventions to reduce progression. Moreover, by customising treatment to a person’s biological and behavioural profile, clinicians could minimise side effects, avoid ineffective treatments, and improve outcomes.
A continuing commitment to obesity research
For more than 25 years, the Pennington–Louisiana Nutrition Obesity Research Center (NORC) has convened over 100 scientists annually to explore emerging topics in obesity and nutrition science.
“Supporting 1.5-day workshops such as the ‘Precision Prevention, Diagnostics, and Treatment of Obesity’ brings top scientists and clinicians from around the world to Pennington Biomedical,” said Dr Leanne Redman, NORC Director, LPFA Endowed Chair in Nutrition, and Associate Executive Director for Scientific Education. “These reports provide a blueprint for the current state of the science and avenues for future research.”
Building a collaborative future
Dr John Kirwan, Executive Director of Pennington Biomedical, commended the team’s contribution:
“This team’s efforts in advancing precision medicine to diagnose, prevent, and treat obesity are truly commendable. At Pennington Biomedical, our work is built on strong partnerships across Louisiana and throughout the United States, strengthened through centres and institutes like the Pennington–Louisiana NORC. We are proud to collaborate with leading research institutions, universities, and healthcare systems nationwide to advance obesity research.”
As the science of precision medicine matures, the report provides a clear framework for how personalised approaches may one day redefine obesity prevention and treatment, improving outcomes for individuals and populations alike.
CCH insight:
Precision approaches to obesity prevention and treatments could massively improve outcomes for people with, or at risk of, obesity. The complex nature of the condition, with its broad range of biological, behavioural, psychological, social and environmental determinants and risk factors, means every patient is unique and requires a personalised intervention. However, this complexity of obesity also makes it difficult to characterise an individual’s obesity phenotype and predict responses to interventions – so there is still a long way to go, a lot more research is needed.
Read More
Exercise Shown to Reduce Artery Hardening After Weight Loss in Adults With Obesity
Key Takeaways:
- Regular exercise after weight loss significantly reduces inflammation and improves blood vessel health in adults living with obesity.
- The GLP-1 receptor agonist liraglutide helped participants maintain weight but did not show the same protective effects against artery hardening.
- Researchers emphasise exercise as an essential factor for maintaining cardiovascular health after weight reduction.
Exercise and heart health after weight loss
Maintaining weight loss through regular exercise, rather than relying solely on the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide, appears to protect against atherosclerosis in adults living with obesity, according to new research from the University of Copenhagen. Atherosclerosis—hardening and narrowing of the arteries due to inflammation and fat deposits—is a major underlying cause of cardiovascular disease (CVD).
The findings were presented at the Annual Meeting of the European Association for the Study of Diabetes (EASD) 2025 in Vienna (15–19 September).
“Our findings reveal that regular exercise is crucial to helping people living with obesity get the full cardiovascular benefits after a substantial weight loss,” said Dr Rasmus Sandsdal, lead author of the study from the University of Copenhagen, Denmark.
Understanding the risk
Cardiovascular disease remains the leading cause of death globally. It often begins with atherosclerosis, in which chronic inflammation and lipid accumulation cause the arteries to stiffen and narrow. If left unchecked, these plaques can rupture and trigger life-threatening events such as heart attacks and strokes.
Obesity contributes to chronic low-grade inflammation and endothelial dysfunction—a condition in which blood vessels lose their ability to contract and relax properly—both of which accelerate atherosclerosis.
While both exercise and GLP-1RAs are known to lower cardiovascular event risk in people with obesity, their specific effects on the development of atherosclerosis during weight loss maintenance have remained unclear—until now.
The study design
The Danish research team conducted a randomised placebo-controlled trial involving 215 adults aged 18–65 years (63% female) living with obesity (BMI 32–43 kg/m²) but without diabetes or other serious chronic conditions.
All participants began an eight-week low-calorie diet (800 kcal per day) using the Cambridge Weight Plan. Of these, 195 participants who achieved at least a 5% reduction in body weight (average loss of 12% or 13.1 kg) entered a one-year maintenance phase. They were randomly assigned to one of four groups:
- Exercise (150 minutes/week of moderate-to-vigorous activity) plus placebo
- Liraglutide treatment (3.0 mg per day)
- Exercise combined with liraglutide
- Placebo only
Researchers measured several key biomarkers at three points—before dieting, at the start of weight maintenance, and after one year. These included inflammatory markers (interleukin-6 [IL-6] and interferon-γ [IFN-γ]), endothelial function markers (intercellular adhesion molecule [ICAM-1], vascular adhesion molecule [VCAM-1], and tissue plasminogen activator [tPA]), and carotid artery intima-media thickness [cIMT], an indicator of arterial wall health measured by ultrasound.
Exercise reduced inflammation and improved arterial health
After one year, participants in both the exercise and liraglutide groups successfully maintained their weight loss. However, significant differences emerged in their cardiovascular health profiles.
Those who exercised—whether or not they also received liraglutide—had notably lower levels of inflammatory biomarkers compared with non-exercising participants. On average, IL-6 levels were 21% lower, and IFN-γ levels were 27% lower.
Exercise also had a favourable effect on endothelial function, reflected in a 6% reduction in VCAM-1, 8% reduction in ICAM-1, and 12% reduction in tPA compared to those who did not exercise. Moreover, carotid artery thickness decreased by an average of 0.024 mm, indicating reduced arterial hardening.
In contrast, treatment with liraglutide alone did not yield any measurable improvements in inflammatory or endothelial biomarkers, nor did it affect carotid artery thickness.
“Regular exercise seems to confer a protective effect against the development of atherosclerosis in people trying to maintain weight loss,” said Dr Sandsdal. “Since both exercise and GLP-1RA treatment were successful at keeping weight off, it seems that exercise plays an important role in mitigating cardiovascular risk factors in a weight-independent manner.”
Implications for long-term health
Exercise offers multiple benefits beyond weight control, including improvements in body composition, cardiorespiratory fitness, and metabolic health. Together, these contribute to better long-term cardiovascular outcomes.
“The most important message from our findings is that, for those trying to maintain weight loss, exercise is crucial in improving long-term health,” said Professor Signe Sørensen Torekov, corresponding author from the University of Copenhagen. “Given the substantial societal and economic costs of obesity-related cardiovascular disease, these findings underscore regular exercise as a critical component of weight management and heart health.”
Study limitations and future research
The authors acknowledged several limitations. The study’s sample size was relatively small, and adherence to structured exercise in real-world conditions may be lower than in a supervised trial setting.
Future studies, they suggested, should explore longer-term interventions and evaluate newer GLP-1 receptor agonists—potentially more potent than liraglutide—in combination with consistent exercise to assess whether similar or enhanced cardiovascular benefits can be achieved.
CCH insight:
We have long known that exercise is important for cardiovascular health, so the results of this study should not be a surprise – exercise provides cardiovascular benefits whether or not you are taking a GLP-1 medication. It is also important to remember that GLP-1 receptor agonists are meant to be taken as an adjunct to a healthy diet and lifestyle, including exercise. This is not just about weight management, but also about maximising health benefits and minimising the risk of developing diseases associated with obesity – such as cardiovascular disease.
Read More
Severe Obesity Accelerates Lung Ageing by Altering Tissue Structure, Study Finds
Key Takeaways:
- Researchers at the University of Bonn have shown that severe obesity causes structural and molecular changes in lung tissue that mimic those of natural ageing.
- Obesity leads to the accumulation of fat within lung connective tissue cells, disrupting their normal function and reducing lung elasticity.
- These findings help explain why people living with obesity often experience breathing difficulties and may face a higher risk of lung-related complications.
Obesity found to accelerate ageing in the lungs
A research team led by Professor Dr Veronika Lukacs-Kornek from the ImmunoSensation2 Cluster of Excellence at the University of Bonn and the Institute for Molecular Medicine and Experimental Immunology (IMMEI) at the University Hospital Bonn (UKB) has discovered that severe obesity causes the lungs to age prematurely. The findings, published in Cell Reports, shed new light on how excessive body weight affects lung function and structure at the molecular level.
The study explored how the lungs respond to nutritional challenges associated with obesity, revealing that excess body fat significantly remodels the extracellular matrix (ECM) – the protein-based “scaffolding” that provides the lungs with their shape, strength, and stability. These alterations in lung architecture closely resemble those typically observed during the natural ageing process, suggesting that obesity accelerates the biological ageing of lung tissue.
Multi-omics analysis reveals profound structural changes
To investigate these effects, the researchers employed state-of-the-art multi-omics techniques – a set of advanced tools that allow for the simultaneous study of proteins, lipids, and genes. This integrative approach enabled the team to map how obesity influences the lungs at multiple biological levels.
By combining molecular analyses with microscopic imaging and functional experiments that tested how lungs perform, the team was able to capture a comprehensive picture of obesity’s impact. They compared the lungs of obese and lean mice, examined human lung fibroblasts (connective tissue cells), and studied the overall composition of lung tissue to identify both molecular and functional differences.
Fat accumulation and loss of elasticity in lung tissue
The results showed that in obesity, lung fibroblasts – the cells responsible for maintaining the connective tissue – begin to accumulate fat, becoming more mobile and displaying early signs of premature ageing. At the same time, the matrisome, which refers to the entire collection of ECM proteins, undergoes significant changes.
These changes disturb the delicate balance of protease inhibitors, enzymes that regulate tissue maintenance and repair. As a consequence, the lungs become less elastic and more prone to stiffness. This reduced elasticity helps explain why people living with obesity often experience shortness of breath and other respiratory difficulties.
“Interestingly, these changes are similar to those normally seen in older people – pointing to obesity as a driver of accelerated lung ageing,” the authors noted.
Overcoming complex research challenges
Studying the lung’s connective tissue presented major technical challenges. The fibroblastic stroma – the supportive framework of the lungs – comprises numerous cell types with highly specialised roles, making it difficult to isolate and analyse. Furthermore, the extracellular matrix itself is notoriously complex: many of its proteins are insoluble and possess intricate structures that resist standard laboratory analysis.
To address this, the team had to develop novel analytical methods that could overcome these limitations and enable the simultaneous study of multiple molecular components within the tissue. This innovative approach has allowed researchers to better understand how obesity-induced changes at the cellular level translate into functional impairments in lung performance.
Implications for understanding obesity-related lung disease
The study provides compelling evidence that obesity accelerates biological ageing processes in the lungs, underscoring the broader systemic impact of excess body weight beyond metabolic and cardiovascular complications.
By demonstrating that obesity alters both the composition and function of lung tissue, the findings open new avenues for exploring how weight management and metabolic interventions might help preserve lung health and mitigate premature ageing in people living with obesity.
CCH insight:
This is an interesting study. It shows that shortness of breath in people with obesity is not simply a case of poor cardiorespiratory fitness or due to mechanical difficulties due to accumulation of adipose tissue in the chest – it actually involves structural changes to lung tissue, similar to biological aging. It would be interesting to compare the lung tissue of people with obesity who have a sedentary inactive lifestyle with that of people with obesity who are active and physically fit, to see if exercise and better cardiorespiratory fitness can prevent these tissue changes and premature aging of the lungs.
Read More