Volume 14 Issue 6, June 2018

The WAVES study, a large randomized controlled trial of school-based childhood obesity prevention, recently reported disappointing outcomes. However, considering the environmental assaults that challenge children’s abilities to eat, play and move for health, it is unrealistic to expect education programmes alone to create the systems-level change necessary to reverse the rising tide of obesity.

Sodium–glucose cotransporter 2 (SGLT2) inhibitors showed cardiorenal protection in patients with diabetes mellitus and cardiovascular disease. However, increase in lower limb amputation with canagliflozin, but not empagliflozin, was reported. The reason for this adverse effect remains speculative and whether it concerns all SGLT2 inhibitors is controversial.

A new study showed that propylthiouracil and methimazole use during pregnancy was associated with increased risk of congenital malformations. Intriguingly, the authors identified dose-dependent effects for methimazole but not propylthiouracil, whereas the recommended switch from methimazole to propylthiouracil during early pregnancy did not reduce the risk of congenital malformations.

Obesity increases the risk of breast cancer and decreases the survival of patients with breast cancer, particularly for postmenopausal, oestrogen receptor-positive breast cancer. New findings now add to the evidence for the detrimental effects of obesity in patients with breast cancer by showing that obesity can cause resistance to therapy.

The prevalence of obesity in adolescents is increasing, and the management of these patients presents unique challenges not seen in adults. Here, Baur and colleagues review the different options for treating obesity in adolescents.

Environmental factors, particularly during early life, are important for the later metabolic health of the individual. Here, Elizabeth Radford explores the extent to which epigenetic inheritance contributes to heredity and whether environmental challenges can result in epigenetic inheritance.

This Review focuses on the emerging preclinical evidence implicating alterations in autophagy as a pathophysiological mechanism underpinning the development of obesity and its complications. The therapeutic potential of pharmacological and nonpharmacological modulation of autophagy in obesity and its sequelae is also discussed.