Treating Severe Obesity - A Multidisciplinary Perspective Lifestyle Considerations and Severe Obesity

Presenter: David Creel

The session emphasized on a personalized approach to managing severe obesity (body mass index, BMI >50), recognizing the complex interplay of physical, behavioral, and emotional factors. Obesity almost always reflects excess body fat at BMI >40.

Practitioners should assess individual history, goals, and challenges, including binge eating, night eating, and liquid calorie intake. Physical activity discussions should address limitations, enjoyment, and social anxiety. Mental health evaluations must include trauma, ADHD, and prior healthcare experiences. Effective treatment integrates behavioral health, emotional regulation, and environmental context. Tools like self-monitoring, collaborative goal setting, and specialty referrals support individualized care and improve long-term outcomes.

Eloralintide Phase 2 in Overweight/Obesity: Design and Study Population

Presenter: Stanley H. Hsia

This Phase 2, double-blind, parallel-group study compared eloralintide, a once-weekly, subcutaneous selective amylin receptor agonist, for weight management in obese or overweight adults with at least one weight-related comorbidity versus placebo. 

Eloralintide was administered for 48 weeks, with a 10-week post-treatment follow-up. Around 250 participants were randomized to placebo or one of four eloralintide doses, with two groups undergoing dose escalation to assess tolerability. The study will provide insights into eloralintide’s potential for long-term weight management.

The Impact of Combined Hormonal Contraceptives on Weight and Calorie Intake in a Weight-Loss Trial 

Presenter: Adnin Zaman

A 12-month behavioral weight-loss trial recruited 59 women [combined hormonal contraceptives (CHC users); n=12, controls; n=12; BMI 27–46 kg/m²; age 18–44].

CHC users had less weight loss than controls (–2.2 kg vs. -7.1 kg). Waist circumference decreased by –3.7 cm in CHC users vs. –9.0 cm in controls. Fat mass reduction was greater in controls vs. CHC users (–5.4 kg vs. -2.6 kg). CHC users showed ~8% less caloric restriction, with no significant difference in moderate-to-vigorous physical activity. CHC use may impair weight loss via reduced dietary adherence rather than physical activity adherence.

BMI Is Associated with Perceived Weight Gain as a Reason for Discontinuing Contraceptive pill use

Presenter: Adnin Zaman

In a study using 2017–2019 National Survey of Family Growth (NSFG) data (N=3,709 women aged 20–49), researchers assessed combined oral contraceptives (COCPs)discontinuation due to perceived weight gain across body mass index (BMI) categories.

Discontinuation rates were 2.6% (underweight (BMI<18.5); aOR: 0.46 (95% CI: 0.11–1.87)), 8.4% (overweight(BMI 25-29.9); aHR: .77 (95% CI: 1.02-3.07)), and 7.7% (obese (BMI≥30); aHR: 1.71 (95% CI: 1.06–2.75)) compared to 5.5% in normal weight women (BMI 18.5-24.9) (reference),. Women with overweight or obesity had over 70% higher odds of discontinuing COCPs due to perceived weight gain. These findings suggest that perception, may influence COCP discontinuation. Addressing weight concerns in contraceptive counseling is essential.

Impact of Pre-Pregnancy GLP-1RA Use on Gestational Diabetes and Preeclampsia Risks

Presenter: Dominick Lemas

The impact of glucagon-like peptide-1 receptor agonists (GLP-1RAs), used for obesity and type 2 diabetes, on pregnancy outcomes has not been ascertained till date. This retrospective cohort study analyzed 29 matched pairs of singleton deliveries with and without pre-pregnancy GLP-1RA exposure. 

Baseline metrics—birth weight, gestational age, NICU admission—were similar. GLP-1RA-exposed pregnancies showed significantly lower gestational diabetes rates (12-month: 11% vs. 53%, p=0.005; 24-month: 21% vs. 48%, p=0.027) but higher preeclampsia incidence (12-month: 68% vs. 32%, p=0.023; 24-month: 69% vs. 38%, p=0.018). Treatment with GLP-1RAs may reduce gestational diabetes risk but an increased risk of preeclampsia. 

The VESPER-1 Trial of MET-097: A Fully Biased and Ultra-Long Acting GLP-1 Receptor Agonist

Presenter: John B. Buse

MET-097 is a fully Gs protein-biased, ultra-long acting GLP-1 receptor agonist with a long half-life enabling gradual exposure and flexible dosing. The VESPER-1 Phase 2b trial randomized 239 overweight/obese participants (mean age 40 years, BMI 36.1 kg/m²) to weekly doses of MET-097 (0.4, 0.6, 0.9 or1.2 mg) or placebo without titration. 

At Week 28, the 1.2 mg group showed a -14.1% weight change from baseline (95% CI: -16.7 -11.6). Adverse event risk differences included nausea (4–23%), vomiting (4–15%), and diarrhea (0–13%). MET-097’s receptor bias and long half-life contribute to its efficacy and tolerability. Ongoing VESPER trials explore simplified titration strategies, supporting MET-097’s potential as a scalable, convenient NuSH analog for weight management.

Long-Term Postpartum Weight Retention and Childhood Obesity: Sex and In Utero Exposure Matter

Presenter: Daniel O. Mensah

This study of 219 mother–child dyads (ages 4–10) from the Health after pregnancy (HAPi) cohort examined the impact of maternal long-term postpartum weight retention (LT-PPWR) and in utero exposure to obesity or gestational diabetes mellitus (GDM) on child BMI z-scores (BMIz). 

LT-PPWR was calculated as weight at 4–10 years postpartum minus pre-pregnancy weight adjusted for child age. a significant interaction (p=0.03): higher LT-PPWR predicted higher BMIz in non-GDM groups, but not in GDM-exposed children. Among females, LT-PPWR strongly predicted BMIz (p=0.005), especially in the Normal Weight–No GDM group. In males, GDM exposure independently predicted higher BMIz (p=0.015), with no LT-PPWR effect. Results persisted after adjusting for energy intake and activity. The findings from the first-of-its kind study highlight sex-specific pathways in childhood obesity and support postpartum weight management and early metabolic screening for GDM-exposed children.

GEN AI: A New Threat to Obesity Knowledge and Understanding, and to Weight Stigma?

Presenter: Stuart W. Flint

This study systematically analyzed 8,415 prompts across six conversational and five image-based Generative AI (GEN AI) platforms to evaluate obesity-related content. The analysis was based on a framework informed by prior weight stigma research. 

The findings revealed that GEN AI sources produce both stigmatizing and non-stigmatizing portrayals of people with obesity (PwO). Conversational platforms often attributed obesity to personal behaviors like overeating and inactivity, offering diet plans (e.g., low-carb, diabetic-friendly) and weight loss advice. Image-based platforms frequently depicted PwO with junk food or in pejorative settings (e.g., exposed stomachs through their cloth, inappropriate attire). While some GEN AI sources acknowledged weight stigma, many reinforced harmful stereotypes. These results highlight the risk of perpetuating stigma through AI-generated content, especially as GEN AI becomes more integrated into healthcare, policy, and media. Urgent improvements are needed to ensure respectful, evidence-based obesity communication.

Obesityweek 2025, November 4th-7th, Atlanta, GA