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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Funding
Dr. Acosta is supported by NIH (K23-DK114460).
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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.
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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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DOI: https://doi.org/10.1038/s41366-024-01492-9