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Clinical Research

Cumulative effect of obesity phenotypes on body weight and body mass index

International Journal of Obesity (2024)Cite this article

Subjects

Abstract

Background

Obesity originates from an imbalance between energy intake and expenditure. Changes in energy intake components (satiation, postprandial satiety, emotional eating) and energy expenditure have been linked to obesity and are referred to as obesity phenotypes. We aim to study if these obesity phenotypes have a cumulative effect on body weight and body mass index (BMI).

Subject/methods

This is a cross-sectional study of adult patients with obesity (BMI > 30 kg/m2) who completed the validated tests to measure the obesity phenotypes. A total of 464 were included in this study.

Interventions/methods

We defined higher calories to fullness during an ad libitum meal as abnormal satiation, accelerated time to half gastric emptying with scintigraphy as abnormal postprandial satiety, higher anxiety score on the Hospital Anxiety and Depression Scale as hedonic eating behavior, and decreased percentage of measured resting energy expenditure as abnormal energy expenditure. The primary analysis was done on the number of phenotypes ( ≤ 1 and ≥ 2) with body weight and BMI using an independent t-test.

Results

Our cohort included 464 patients (mean [SD] age 42.0 [10.9] years, 79% females, weight 111.2 [22.9] kg, BMI 38.9 [7.0] kg/m2). There were 294 patients who had ≤ 1 phenotype, and 170 patients with ≥ 2 phenotypes with no baseline demographical differences (i.e., age and sex). Having ≥ 2 phenotypes was associated with higher body weight (115 [25] kg vs. 109 [21] kg; p = 0.004), BMI (40 [8] kg/m2 vs. 38 [7] kg/m2; p = 0.02) and waist (118 [15] cm vs. 115 [13] cm; p = 0.04) and hip (129 [14] cm vs. 125 [13] cm; p = 0.01) circumferences compared to ≤ 1 phenotype.

Conclusion

Obesity phenotypes are associated with an additive effect on the body weight and BMI. Patients who have multiple obesity phenotypes may require a more aggressive approach to enhance weight loss.

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Fig. 1: Clinical tests to classify obesity phenotypes.
Fig. 2: Association between number of obesity phenotypes and clinical parameters.
Fig. 3: Association between number of obesity phenotypes and clinical parameters.

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Data availability

Deidentified data will be made available for the journal upon request.

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Funding

Dr. Acosta is supported by NIH (K23-DK114460).

Author information

Authors and Affiliations

  1. Precision Medicine for Obesity Program, Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Wissam Ghusn, Lizeth Cifuentes, Diego Anazco, Sima Fansa, Elif Tama, Alejandro Campos, Khushboo Gala, Daniela Maria Hurtado & Andres Acosta

  2. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Medicine, Mayo Clinic, Jacksonville, FL, USA

    Elif Tama & Daniela Maria Hurtado

Authors
  1. Wissam Ghusn
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  2. Lizeth Cifuentes
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  3. Diego Anazco
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  4. Sima Fansa
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Contributions

All authors had full access to all the data and statistical analyses. AA had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. WG, LC, DA, SF, ET, AL, KG, DH, AA were responsible of writing the first draft and reviewing the manuscript. WG and LC performed the analysis. AA and DH supervised the manuscript writing.

Corresponding author

Correspondence to Andres Acosta.

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Competing interests

Dr. Acosta is a stockholder in Gila Therapeutics, Phenomix Sciences; he served as a consultant for Rhythm Pharmaceuticals, Nestle, Structure Therapeutics and Amgen Pharmaceuticals. There are no other disclosures. All other authors declare no competing financial interests.

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Ghusn, W., Cifuentes, L., Anazco, D. et al. Cumulative effect of obesity phenotypes on body weight and body mass index. Int J Obes (2024). https://doi.org/10.1038/s41366-024-01492-9

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