Abstract Purpose of Review Protein intake is recognized as a key nutritional factor crucial for optimizing Metabolic Bariatric Surgery (MBS) outcomes by preventing protein malnutrition, preserving fat-free mass, and inducing satiety. This paper discusses the current evidence regarding protein intake and its impact on clinical outcomes following MBS. Recent Findings There are considerable gaps in the understanding of protein requirements following MBS, as existing guidelines are based on limited and inconsistent reports. This highlights the urgent need for updated clinical practice recommendations grounded in high-quality evidence. Summary Further investigation using robust methodologies is essential to address existing research gaps related to the individualization of protein requirements following MBS. Future research should consider factors such as the time elapsed since surgery, the form and quantity of protein consumed, and necessary adjustments for physical activity. Ultimately, in alignment with recent literature, a more specific and personalized dietary protein approach should be examined.

To highlight recent research on antidepressant use and weight change and explore best clinical practices for reducing weight gain and obesity risk in individuals with depression. Research on antidepressant use and weight gain suggests that genetic and biological factors including metabolizer phenotypes and inflammation can help to predict an individual’s threshold for weight change among specific agents. For individuals with increased susceptibility to metabolic complications, medications including bupropion, fluoxetine, and newer agents (e.g., gepirone) have shown to be efficacious in improving depressive symptoms while concurrently reducing metabolic risks. Additional areas of focus following antidepressant related weight gain include switching to a weight neutral drug alternative, integrated behavioral interventions, and/or pharmacotherapy including GLP-1 receptor agonists (e.g., metformin, liraglutide). Individuals experiencing depression are at heightened risk of metabolic disorders and weight gain, which may be further exacerbated by antidepressant treatment. The increased support of weight neutral antidepressant agents in addition to innovative lifestyle interventions, breakthroughs in drug mechanisms, anti-obesity medications and overall familiarity with the side effects of each antidepressant class will help clinicians make appropriate decisions when treating patients with depression.

Eating behaviour-focused interventions are essential for improving health and weight-related outcomes in patients undergoing metabolic bariatric surgery (MBS). This work aims to examine the content of eating behaviour-focused weight management interventions adjunct to MBS in terms of the type and quantity of behaviour change techniques (BCTs). A literature search retrieved randomised controlled and parallel group trials up to March 2024. A total of 25 trials were included in the final analysis. Trained coders used Michie’s BCT taxonomy v1.0 to code intervention components from each trial and applied descriptive methods to report the types and frequency of BCTs. Calculated effect sizes were used to compare the impact of the experimental and comparator arms. Common BCTs applied in eating behaviour-focused interventions were ‘4.1 Instruction on how to perform a behaviour’ (68%), ‘2.3 Self-monitoring of behaviour’ (56%), ‘1.1 Goal setting (behaviour)’ (52%), ‘1.2 Problem solving’ (44%), ‘3.1 Social support (unspecified)’ (40%), and ‘1.4 Action planning’ (40%). However, the BCTs associated with the largest intervention effect sizes (2.1. Monitoring of behaviour by others without feedback and 4.2. Information about antecedents) were not among the most frequently employed techniques. Only one study described the intervention explicitly using BCT taxonomy groupings. In more than half of the studies (52%), authors did not use BCTs to describe interventions. This work highlights the importance of using standard frameworks for reporting the components of behavioural interventions to enhance scientific replication, evidence synthesis, and the ability to test interventions’ effectiveness in the future.

To develop Mexico’s first methodologically rigorous clinical practice guideline for the management of adult overweight and obesity. The target audiences are interdisciplinary healthcare professionals across healthcare systems who are the first point of contact for patients with obesity in Mexico, patients, and health system decision makers. A review of recent international obesity clinical practice guidelines and an expert consensus process identified: i) common recommendations appropriate for implementation in Mexico and ii) knowledge gaps requiring the formulation of new recommendations. In all, 20 new recommendations and 20 good practice statements were developed using the GRADE Evidence-to-Decision Framework and expert consensus. Overweight and obesity negatively impact the health and well-being of individuals and populations in Mexico. This guideline aims to establish a new evidence-based, patient-centered, non-stigmatizing, and practical treatment and management framework, based on the fundamental principles of chronic disease prevention and management.

This article discusses what person-centred care is; why it is critically important in providing effective care of a chronic, complex disease like obesity; and what can be learnt from international best practice to inform global implementation. There are four key principles to providing person-centred obesity care: providing care that is coordinated, personalised, enabling and delivered with dignity, compassion and respect. The Canadian 5AsT framework provides a co-developed person-centred obesity care approach that addresses complexity and is being tested internationally. Embedding person-centred obesity care across the globe will require a complex system approach to provide a framework for healthcare system redesign, advances in people-driven discovery and advocacy for policy change. Additional training, tools and resources are required to support local implementation, delivery and evaluation. Delivering high-quality, effective person-centred care across the globe will be critical in addressing the current obesity epidemic.

The COVID-19 pandemic is associated with increased levels of stress, anxiety and depression in the population. These are associated with unhealthy eating patterns and sedentary behaviour. In turn, this may increase risk of obesity or aggravate it. This narrative review discusses the link between adverse mental health states and weight related behaviours. We present emerging evidence for this phenomenon during the COVID-19 pandemic in individuals with and without pre-existing obesity. A sizeable proportion of the population exhibits deterioration in mental health during the pandemic and those affected often report unhealthy weight-related behaviours such as “junk food” consumption and physical inactivity. Women, individuals with obesity, and those with pre-existing mental health conditions seem to be particularly at risk for overeating in response to stress (i.e. emotional eating). A number of psychological interventions including cognitive behavioural therapy and self-compassion may be effective in improving mental health and emotional eating patterns among the general population and particularly in individuals living with obesity. There is a need to complement efforts to improve mental health in the general population during the COVID-19 pandemic with targeted action to improve physical activity levels and healthy eating particularly among groups at-risk. This may be achieved by reducing disruptions to specialist and primary healthcare services and facilitating access to psychological interventions that address stress-related eating behaviours. Additional studies that examine such interventions, especially those that are delivered remotely, are urgently needed.

Restrictive diets, such as low-calorie diets, are difficult to maintain in the long term. For this reason, their popularity has decreased compared to non-restrictive approaches, which instead promote healthy eating strategies. Since both strategies may entail different neurobiological mechanisms, this review will examine the current evidence on the effects of restrictive and non-restrictive interventions on neurobehavioral factors. Restrictive diets appear to improve eating behaviors, and the evidence reviewed argues against the notion that they may worsen the severity of binge eating. Moreover, they may lead to short-term changes in brain structure and improvements in cerebrovascular markers which, in turn, could impact eating behaviors. Non-restrictive interventions may have a positive effect on weight management and eating behaviors. However, evidence of their neural effects is scarce. Small sample sizes, short follow-ups, and the absence of control groups are limitations of the studies targeting both interventions. Rigorous long-term randomized studies are needed to examine the neurobehavioral effects of restrictive and non-restrictive approaches.

The aims of this narrative review were to (1) synthesise the literature on the relationship between screen time and important mental health outcomes and (2) examine the underpinning factors that can influence this association. Paralleling the rise of mental health issues in children and adolescents is the ubiquitous overuse of screens, but it is unclear how screen time is related to important mental health outcomes and whether this association differs by gender, age and screen type. Medline/PubMed, PsychINFO and Google Scholar databases were searched on December 2019 for articles published mainly in the last 5 years. The search focused on two main concepts: (i) screen time and (ii) mental health outcomes including anxiety, depression, psychological and psychosocial well-being and body image concerns. Sixty studies were included in the review. Higher levels of screen time were associated with more severe depressive symptoms. We found moderate evidence for an association between screen time and poor psychological well-being and body dissatisfaction especially among females. Relationships between screen time and anxiety were inconsistent and somewhat gender specific. Social media use was consistently associated with poorer mental health. Higher levels of screen time are generally associated with poorer mental health outcomes, but associations are influenced by screen type, gender and age. Practitioners, parents, policy makers and researchers should collectively identify and evaluate strategies to reduce screen time, or to use screens more adaptively, as a means of promoting better mental health among children and adolescents.

Describe the state of knowledge on how the retail food environment contributes to diet-related health and obesity among Indigenous populations, and assess how the literature incorporates Indigenous perspectives, methodologies and engagement throughout the research process. Outcomes included dietary behaviour (purchasing, intakes and diet quality) and diet-related health outcomes (weight-related outcomes, non-communicable diseases and holistic health or definitions of health as defined by Indigenous populations involved in the study). Of fifty included articles (1996–2019), the largest proportions described Indigenous communities in Canada (20 studies, 40%), the USA (16, 32%) and Australia (9, 18%). Among articles that specified the Indigenous population of focus (42 studies, 84%), the largest proportion (11 studies, 26%) took place in Inuit communities, followed by Aboriginal and Torres Strait Islander communities (8 studies, 19%). The included literature encompassed four main study designs: type A, dietary intakes of store foods (14 studies, 28%), and type B, store food environments (16, 32%), comprised the greatest proportion of articles; the remainder were type C, store food environments and diet (7, 14%), and type D, store food environment interventions (13, 26%). Of the studies that assessed diet or health outcomes (36, 72%), 22 (61%) assessed dietary intakes; 16 (44%) sales/purchasing; and 8 (22%) weight-related outcomes. Store foods tended to contribute the greatest amount of dietary energy to the diets of Indigenous peoples and increased non-communicable disease risk as compared to traditional foods. Multi-pronged interventions appeared to have positive impacts on dietary behaviours, food purchasing and nutrition knowledge; promotion and nutrition education alone had more mixed effects. Of the nine studies which were found to have strong engagement with Indigenous populations, eight had moderate or high methodological quality. Eighteen studies (36%) did not mention any engagement with Indigenous populations. The literature confirmed the importance of store foods to the total energy intake of the contemporary diets of Indigenous people, the gaps in accessing both retail food environments and traditional foods and the potential for both new dietary assessment research and retail food environment intervention strategies to better align with and privilege Indigenous Ways of Knowing.

To review the status of community-based disordered eating and obesity prevention programs from 2014 to 2019. In the last 5 years, prevention programs have found success in intervening with children and parental figures in wellness centers, physical activity centers, childcare centers, workplaces, online, and over-the-phone through directly reducing disordered eating and obesity or by targeting risk factors of disordered eating and obesity. Community-based prevention programs for disordered eating and programs targeting both disordered eating and obesity were scarce, highlighting the critical need for the development of these programs. Qualities of the most effective programs were those in which parents and children were educated on physical activity and nutrition via multiple group-based sessions. Limitations of current prevention programs include few programs targeting high-risk populations, a dearth of trained community members serving as facilitators, inconsistent reporting of adherence rates, and few direct measurements of disordered eating and obesity, as well as few long-term follow-ups, precluding the evaluation of sustained effectiveness.

This narrative review summarizes literature on the stigma and prejudices experienced by individuals based on their weight in the context of romantic relationships. Individuals presenting with overweight or obesity, particularly women, are disadvantaged in the formation of romantic relationships compared with their normal-weight counterparts. They are also more prone to experience weight-based stigmatization towards their couple (from others), as well as among their couple (from their romantic partner). Currently available studies showed that weight-based stigmatization by a romantic partner was found to be associated with personal and interpersonal correlates, such as body dissatisfaction, relationship and sexual dissatisfaction, and disordered eating behaviors. Scientific literature on weight-based stigmatization among romantic relationships is still scarce. Prospective researches are clearly needed to identify consequences of this specific type of stigmatization on individuals’ personal and interpersonal well-being. The use of dyadic designs could help to deepen our understanding as it would take into account the interdependence of both partners.

Depressive symptoms may be a psychological correlate of weight-based teasing from peers and/or family. However, it is unclear whether the association of weight-based teasing with depressive symptoms differs by time (short term vs. long term), sex (males vs. females), or source (family vs. peers). The purpose of this systematic review was to (1) examine whether the frequency of weight-based teasing differs according to sex and source and; (2) examine whether the association of weight-based teasing with depressive symptoms varies according to time, sex, and source. On February 16, 2018, a combination of keywords within three concepts, (i) children and adults, (ii) weight-based teasing source, and (iii) mental health outcomes, were searched in four databases (PubMed, PsycINFO, Scopus, and Web of Science) for relevant articles. Cross-sectional and longitudinal original research articles were included, and studies were excluded if the relationship between weight-based teasing and depressive symptoms was not explicitly measured. The search yielded 3572 articles, and nineteen studies were included in the final analysis. Experiences of weight-based teasing occurred significantly more among girls than boys. Weight-based teasing was significantly associated with depressive symptoms in both short and long term. Weight-based teasing exhibited a greater association with depressive symptoms in girls vs. boys and when it came from multiple sources than from either source alone. However, it remains uncertain whether one source of teasing is more common than the other, since only two studies found peers to be a more common source of weight-based teasing compared to family. Weight-based teasing from peers and family is associated with depressive symptoms, and girls are more psychologically vulnerable than boys. Interventions are required to reduce weight-based teasing and its harmful psychological effects.

In this review, we critically examined recent evidence pertaining to the efficacy of peer-delivered physical activity interventions. Peer-delivered interventions appear to represent an efficacious, although under-utilized, means of promoting health-enhancing physical activity, among diverse populations across the lifespan, and in different settings. Nevertheless, research has largely failed to identify the salient behaviors/strategies of peer leaders that can promote behavior change among target populations, as well as explanatory mechanisms (i.e., mediators) of intervention effects. Balanced against recent evidence for the efficacy of peer-delivered interventions to promote physical activity, work in this area appears impeded by an absence of peer-centric explanatory frameworks and theory that may optimize both intervention delivery and efficacy/effectiveness.

Misperception of children’s weight status is prevalent among parents and children themselves and may impact parents’ and children’s health behaviors. This study was conducted in order to provide a descriptive systematic review of research on factors influencing parents’ and children’s misperceptions of children’s weight status published in the past 5 years. Factors studied most often in relation to parents’ and children’s misperception included children’s weight status, gender, and age, as well as parents’ weight status, parental education levels and socioeconomic status, and ethnicity. Most determinants that were found to have a significant influence on misperception in parents also did in children. The literature on misperception of children’s weight status is extensive. Most determinants assessed in included studies were known determinants of childhood obesity. Further research should be directed toward better understanding the impact of weight status perception (whether it is accurate or not) on health behaviors and weight gain over time.

The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments. Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.

To conduct a systematic literature review of empirical peer-reviewed published studies on the prevalence of weight bias among students, pre-service, and in-service teachers and its impact on the educational experiences and health of students from kindergarten to postsecondary settings. Keywords were searched on three main concepts, (i) weight bias/stigma, (ii) obesity/overweight, and (iii) education, within eight databases. Our search yielded 8323 individual records, of which 45 studies satisfied our inclusion criteria. Most studies were conducted in K-12 school settings (n = 41), were quantitative in design (n = 37), and used student samples (n = 18). Weight bias is prevalent in educational settings, among peers at school as well as pre-service and in-service teachers, and negatively impacts students’ health and educational experiences. These results highlighted the impact of weight bias in creating inequity for students with obesity as well as several underexamined areas, such as weight bias in postsecondary settings and attitudes among teachers and pre-service teachers. Innovative strategies to address weight bias in educational settings are needed.

This review aims to summarize recent research on the effects of social media-delivered weight management interventions on weight loss and the impact of social media use on body image concerns in women and adolescent girls. Evidence supports the feasibility, but not the efficacy, of studies using single-component social media-delivered weight management interventions (i.e., including no other modes of intervention delivery) in women. Studies conducted in adolescent girls and women suggest that the impact of social media on body image outcomes is mostly detrimental, but is dependent on the context (e.g., exposure to idealized social media appearance images), peers’ feedback, and constructs, such as appearance comparison tendency. More research is needed to conclude on the efficacy of social media-delivered interventions on both weight and body image outcomes and to understand how and when exposure to social media could promote effective weight management and also advocate positive body image in women.

The purpose of this study was to review public and private sector obesity policies in Canada and to make recommendations for future evidence-based obesity prevention and management strategies. Synthesis of obesity prevention and management policies and research studies are presented in three primary themes: (1) Increased awareness about the impact of weight bias and obesity stigma in Canada; (2) Inadequate government obesity prevention and management policies and strategies; and (3) Lack of comprehensive private sector obesity prevention and management policies. Findings suggest that in Canada, obesity continues to be treated as a self-inflicted risk factor, which affects the type of interventions and approaches that are implemented by governments or covered by private health plans. The lack of recognition of obesity as a chronic disease by Canadian public and private payers, health systems, employers, and the public, has a trickle-down effect on access to evidence-based prevention and treatment. Although there is increasing recognition and awareness about the impact of weight bias and obesity stigma on the health and social well-being of Canadians, interventions are urgently needed in education, healthcare, and public policy sectors. We conclude by making recommendations for the advancement of evidence-based obesity prevention and management policies that can improve the lives of Canadians affected by obesity.

Our systematic review aims to assess the overall evidence available in the literature regarding the role of physical activity (PA) in individuals with binge eating disorder (BED) and better understand the potential underlying mechanisms of action. Currently, the most effective and well-established psychological treatment for BED is cognitive behavioral therapy (CBT) with a remission rate around 80%. CBT is sometimes combined with pharmacotherapy targeting comorbidities associated with BED, such as obesity and depression. Another avenue of treatment that has been less studied is PA. It has been suggested that PA addresses the underlying mechanisms of BED and, thus, increases treatment efficiency. This systematic review provides additional knowledge concerning the benefits of PA in the treatment of individuals with BED including reduction of binge eating (BE) episodes and improvement in other associated comorbidities. Potential mechanisms of action of PA include neurochemical alterations affecting the reward system, reduction of negative affect, and its anorexigenic effects.

The primary objective of this review is to identify dietary patterns with beneficial effects on cardiovascular health of adults with type 2 diabetes. The prevalence of diabetes is increasing globally. People with diabetes have a greater risk for cardiovascular disease. Mediterranean diet, dietary approaches to stop hypertension diet, vegetarian diet, traditional Korean diet, Japanese diet, and low-glycemic-index diet can reduce cardiovascular disease risk in people with diabetes. Dietary intake is a key modifiable factor in the management of diabetes and plays a significant role in limiting the incidence of cardiovascular diseases.

The aim of this review is to describe and discuss weight loss-induced variations in appetite in women and factors responsible for these changes. Studies have shown postweight loss increases in fasting and postprandial appetite in individuals engaged in weight loss trials, especially in women. Similarly, appetite-related peptides associated to the homeostatic control of feeding, such as leptin, ghrelin and peptide YY, were also found to be altered in way that promotes increased appetite after weight loss interventions. Sustained caloric deficits also drive increases in the frequency and strength of food cravings, food reward and seem to enhance oro-sensory sensations in women who lost weight. The menstrual cycle has also been to shown to influence caloric intake in women, more specifically food cravings. On the other hand, caloric restriction seems to increase cognitive restraint, decrease habitual disinhibition and susceptibility to hunger among women engaged in weight loss trials. Neural analysis corroborates these results, showing increased activation in brain areas involved in food reward and self-control processing. In conclusion, evidence supports that weight loss increases appetite sensations, and promotes changes in homeostatic and non-homeostatic control of feeding, which collectively seem to upregulate appetite in women.

The aim of this paper is to assess the association between sedentary behaviours, including screen time, and risk of obesity in adults. A review of 10 systematic reviews was undertaken. Available evidence is generally not supportive of associations between sedentary behaviour and obesity in adults. Most studies that found significant associations indicated mostly small effect sizes. Somewhat more consistent associations were shown for screen time (mainly TV viewing), among older adults, and for pre-adult sedentary behaviour to increase the risk of obesity in adulthood. Some evidence also exists for breaks in sedentary time to be associated with a more favourable BMI, and for use of a car to be associated with greater risk of obesity. There is limited evidence for an association between sedentary behaviour in adulthood and obesity and any association that exists does not seem to be causal. Future research is required investigating potentially positive effects for frequent breaks from sitting, less car use, and an uncoupling of TV viewing and dietary intake.

Obesity remains a prominent societal threat and burden despite well-promoted prevention and treatment strategies, such as regular engagement in physical activity. Obese individuals, in particular, may be prone to inactivity as a result of a variety of displeasure-related parameters resulting from exercise, such as dyspnea, for instance. This brief conceptual review discusses the integral roles of exercise-induced affective responses within a novel conceptual-based neurocognitive affect-related model. Specifically, this model includes three pathways: (1) pathway A proposes that neurocognition, and especially, executive function-based cognition, may play an influential role in fostering exercise-induced affective responses, (2) pathway B connects an individual’s affective response from exercise to their future exercise behavior, and (3) pathway C suggests a cyclical, bi-directional relationship with executive function indirectly influencing future exercise behavior via affective responses to exercise, and exercise itself playing an important role in executive functioning. Future studies should empirically test this model, which may have utility for promoting exercise among the obese population.