{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T14:10:36Z","timestamp":1784124636345,"version":"3.55.0"},"reference-count":93,"publisher":"Bioscientifica","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Obesity and thyroid disorders are highly prevalent conditions with complex, bidirectional interactions. Thyroid hormones, particularly triiodothyronine, regulate energy expenditure, thermogenesis, and lipid metabolism, while excess adiposity can modulate hypothalamic\u2013pituitary\u2013thyroid (HPT) axis activity. Individuals with obesity frequently exhibit elevated thyroid-stimulating hormone (TSH) levels in the absence of true thyroid disease, suggesting an adaptive rather than pathological response. The balance of current evidence suggests that non-autoimmune hyperthyrotropinemia predominates in severe and morbid obesity, whereas autoimmune hypothyroidism may be relatively more common in mild-to-moderate obesity. Obesity also induces structural changes in the thyroid, including increased volume, hypoechogenicity, and adipocyte infiltration, which may reverse with weight loss. Weight reduction interventions \u2013 including dietary strategies, bariatric surgery, and pharmacotherapy \u2013 consistently reduce TSH with variable effects on free thyroid hormones. Emerging therapies, such as that with GLP-1 receptor agonists, may influence the HPT axis directly or indirectly through weight loss, although data remain limited. Understanding the interplay between obesity and thyroid function is important for the appropriate interpretation of thyroid function tests, differentiation of adaptive versus pathological changes, and optimization of treatment strategies in patients with excess adiposity.<\/jats:p>","DOI":"10.1530\/etj-26-0082","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T16:11:27Z","timestamp":1782317487000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-17","source":"Crossref","is-referenced-by-count":0,"title":["Obesity-related thyroid reflections: from weight gain to weight loss"],"prefix":"10.1530","volume":"15","author":[{"given":"Laura","family":"Croce","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia 1 , ,","place":["Pavia, Italy"]},{"name":"Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS 2 , ,","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Chiardi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia 1 , ,","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Anna","family":"Marchiselli Dell\u2019Innocenti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia 1 , ,","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Parisi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia 1 , ,","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6464-2334","authenticated-orcid":true,"given":"Mario","family":"Rotondi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Therapeutics, University of Pavia 1 , ,","place":["Pavia, Italy"]},{"name":"Unit of Endocrinology and Metabolism, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS 2 , ,","place":["Pavia, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"2026071509264313800_bib1","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1016\/S0140-6736(23)02750-2","article-title":"Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults","volume":"403","author":"NCD Risk Factor Collaboration (NCD-RisC)","year":"2024","journal-title":"Lancet"},{"key":"2026071509264313800_bib2","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/nrendo.2018.18","article-title":"Global epidemiology of hyperthyroidism and hypothyroidism","volume":"14","author":"Taylor","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"2026071509264313800_bib3","doi-asserted-by":"crossref","first-page":"R137","DOI":"10.1530\/EJE-14-0067","article-title":"Mechanisms in endocrinology: the crosstalk between thyroid gland and adipose tissue: signal integration in health and disease","volume":"171","author":"Santini","year":"2014","journal-title":"Eur J Endocrinol"},{"key":"2026071509264313800_bib4","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3390\/nu16010087","article-title":"Subclinical hypothyroidism in patients with obesity and metabolic syndrome: a narrative review","volume":"16","author":"Biondi","year":"2023","journal-title":"Nutrients"},{"key":"2026071509264313800_bib5","doi-asserted-by":"crossref","first-page":"9434","DOI":"10.3390\/ijerph18189434","article-title":"Obesity and thyroid axis","volume":"18","author":"Walczak","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026071509264313800_bib6","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1152\/physrev.00030.2013","article-title":"Thyroid hormone regulation of metabolism","volume":"94","author":"Mullur","year":"2014","journal-title":"Physiol Rev"},{"key":"2026071509264313800_bib7","doi-asserted-by":"crossref","first-page":"4019","DOI":"10.1210\/jc.2004-2225","article-title":"Small differences in thyroid function may be important for body mass index and the occurrence of obesity in the population","volume":"90","author":"Knudsen","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib8","doi-asserted-by":"crossref","first-page":"299","DOI":"10.2147\/IJGM.S206983","article-title":"Relationship between thyroid dysfunction and body weight: a not so evident paradigm","volume":"12","author":"R\u00edos-Prego","year":"2019","journal-title":"Int J Gen Med"},{"key":"2026071509264313800_bib9","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1172\/JCI109590","article-title":"Dietary-induced alterations in thyroid hormone metabolism during overnutrition","volume":"64","author":"Danforth","year":"1979","journal-title":"J Clin Investig"},{"key":"2026071509264313800_bib10","doi-asserted-by":"crossref","first-page":"3460","DOI":"10.1210\/en.2010-0026","article-title":"High-fat diet increases thyrotropin and oxygen consumption without altering circulating 3,5,3\u2019-triiodothyronine (T3) and thyroxine in rats: the role of iodothyronine deiodinases, reverse T3 production, and whole-body fat oxidation","volume":"151","author":"Araujo","year":"2010","journal-title":"Endocrinology"},{"key":"2026071509264313800_bib11","article-title":"Causal association between obesity and hypothyroidism: a two-sample bidirectional Mendelian randomization study","volume":"14","author":"Qiu","year":"2023","journal-title":"Front Endocrinol"},{"key":"2026071509264313800_bib12","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.1029376","article-title":"The pattern of TSH and fT4 levels across different BMI ranges in a large cohort of euthyroid patients with obesity","volume":"13","author":"Mele","year":"2022","journal-title":"Front Endocrinol"},{"key":"2026071509264313800_bib13","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2025.1538627","article-title":"The effects of obesity on thyroid function in a metabolically healthy high-fat, high-carbohydrate diet-induced obese rat model","volume":"16","author":"Pather","year":"2025","journal-title":"Front Endocrinol"},{"key":"2026071509264313800_bib14","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1530\/EJE-11-0261","article-title":"Association between serum TSH concentration within the normal range and adiposity","volume":"165","author":"de Moura Souza","year":"2011","journal-title":"Eur J Endocrinol"},{"key":"2026071509264313800_bib15","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.mce.2009.06.005","article-title":"Obesity and thyroid function","volume":"316","author":"Reinehr","year":"2010","journal-title":"Mol Cell Endocrinol"},{"key":"2026071509264313800_bib16","doi-asserted-by":"crossref","first-page":"4484","DOI":"10.1097\/MS9.0000000000003428","article-title":"The impact of weight loss interventions on thyroid function: a systematic review and meta-analysis","volume":"87","author":"Nayak","year":"2025","journal-title":"Ann Med Surg"},{"key":"2026071509264313800_bib17","doi-asserted-by":"crossref","first-page":"e4251","DOI":"10.1210\/clinem\/dgab183","article-title":"Causal association between serum thyrotropin and obesity: a bidirectional, mendelian randomization study","volume":"106","author":"Wang","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib18","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1111\/cen.12311","article-title":"Association between thyroid hormones and body fat in euthyroid subjects","volume":"80","author":"Ren","year":"2014","journal-title":"Clin Endocrinol"},{"key":"2026071509264313800_bib19","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1530\/EJE-08-0734","article-title":"Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?","volume":"160","author":"Rotondi","year":"2009","journal-title":"Eur J Endocrinol"},{"key":"2026071509264313800_bib20","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1046\/j.1365-2265.2003.01836.x","article-title":"The effect of body weight and weight loss on thyroid volume and function in obese women","volume":"59","author":"Sari","year":"2003","journal-title":"Clin Endocrinol"},{"key":"2026071509264313800_bib21","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1089\/thy.2006.16.73","article-title":"Thyroid function in humans with morbid obesity","volume":"16","author":"Michalaki","year":"2006","journal-title":"Thyroid"},{"key":"2026071509264313800_bib22","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3904\/kjim.2008.23.2.53","article-title":"Free T4 is negatively correlated with body mass index in euthyroid women","volume":"23","author":"Shon","year":"2008","journal-title":"Korean J Intern Med"},{"key":"2026071509264313800_bib23","doi-asserted-by":"crossref","first-page":"3614","DOI":"10.1210\/jc.2010-1245","article-title":"Thyroid and obesity: an intriguing relationship","volume":"95","author":"Biondi","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib24","doi-asserted-by":"crossref","first-page":"3965","DOI":"10.1210\/jc.2009-2798","article-title":"Investigations of thyroid hormones and antibodies in obesity: Leptin levels are associated with thyroid autoimmunity independent of bioanthropometric, hormonal, and weight-related determinants","volume":"95","author":"Marzullo","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib25","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.3389\/fimmu.2019.02349","article-title":"The impact of obesity on thyroid autoimmunity and dysfunction: a systematic review and meta-analysis","volume":"10","author":"Song","year":"2019","journal-title":"Front Immunol"},{"key":"2026071509264313800_bib26","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/cen.13095","article-title":"Effects of thyrotrophin, thyroid hormones and thyroid antibodies on metabolic parameters in a euthyroid population with obesity","volume":"85","author":"Temizkan","year":"2016","journal-title":"Clin Endocrinol"},{"key":"2026071509264313800_bib27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0169283","article-title":"The prevalence, incidence and natural course of positive antithyroperoxidase antibodies in a population-based study: tehran thyroid study","volume":"12","author":"Amouzegar","year":"2017","journal-title":"PLoS One"},{"key":"2026071509264313800_bib28","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1055\/a-0887-6213","article-title":"Long-term variations of antithyroperoxidase antibodies and its clinical significance","volume":"51","author":"Keyhanian","year":"2019","journal-title":"Horm Metab Res"},{"key":"2026071509264313800_bib29","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1046\/j.1365-2265.2003.01633.x","article-title":"Thyroid peroxidase and thyroglobulin autoantibodies in a large survey of populations with mild and moderate iodine deficiency","volume":"58","author":"Pedersen","year":"2003","journal-title":"Clin Endocrinol"},{"key":"2026071509264313800_bib30","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1530\/eje.0.1430639","article-title":"Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large, unselected population. The health study of nord-trondelag (HUNT)","volume":"143","author":"Bjoro","year":"2000","journal-title":"Eur J Endocrinol"},{"key":"2026071509264313800_bib31","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1210\/jcem.87.2.8182","article-title":"Serum TSH, T(4), and thyroid antibodies in the United States Population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III)","volume":"87","author":"Hollowell","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib32","first-page":"591","article-title":"Autoantibodies to thyroperoxidase (TPOAb) in a large population of euthyroid subjects: implications for the definition of TPOAb reference intervals","volume":"49","author":"Z\u00f6phel","year":"2003","journal-title":"Clin Lab"},{"key":"2026071509264313800_bib33","doi-asserted-by":"crossref","first-page":"4236","DOI":"10.1210\/jc.2007-0287","article-title":"National Health and Nutrition Examination Survey III thyroid-stimulating hormone (TSH)-thyroperoxidase antibody relationships demonstrate that TSH upper reference limits may be skewed by occult thyroid dysfunction","volume":"92","author":"Spencer","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib34","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1007\/s40618-013-0024-y","article-title":"Male gender differences in the thyroid ultrasound features, thyroid peroxidase antibodies and thyroid hormone levels: a large population-based study","volume":"37","author":"Shinkov","year":"2014","journal-title":"J Endocrinol Investig"},{"key":"2026071509264313800_bib35","doi-asserted-by":"crossref","first-page":"2077","DOI":"10.1007\/s40618-022-01839-x","article-title":"Possible added value of thyroglobulin antibody (TgAb) testing in the evaluation of thyroidal status of subjects with overweight or obesity","volume":"45","author":"Fierabracci","year":"2022","journal-title":"J Endocrinol Investig"},{"key":"2026071509264313800_bib36","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1002\/oby.21796","article-title":"Reference values for TSH may be inadequate to define hypothyroidism in persons with morbid obesity: Di@bet.es study","volume":"25","author":"Vald\u00e9s","year":"2017","journal-title":"Obesity"},{"key":"2026071509264313800_bib37","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0140-6736(25)00355-1","article-title":"Global, regional, and national prevalence of adult overweight and obesity, 1990\u20132021, with forecasts to 2050: a forecasting study for the global burden of disease study 2021","volume":"405","author":"GBD 2021 Adult BMI Collaborators","year":"2025","journal-title":"Lancet"},{"key":"2026071509264313800_bib38","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s12020-025-04317-5","article-title":"Differences in autoimmune thyroid diseases between females and males: the result of a complex interconnection of factors","volume":"89","author":"Battheu","year":"2025","journal-title":"Endocrine"},{"key":"2026071509264313800_bib39","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s12020-013-9928-8","article-title":"Raised serum TSH in morbid-obese and non-obese patients: effect on the circulating lipid profile","volume":"45","author":"Rotondi","year":"2014","journal-title":"Endocrine"},{"key":"2026071509264313800_bib40","doi-asserted-by":"crossref","first-page":"G1","DOI":"10.1530\/EJE-19-0893","article-title":"European Society of endocrinology clinical practice guideline: endocrine work-up in obesity","volume":"182","author":"Pasquali","year":"2020","journal-title":"Eur J Endocrinol"},{"key":"2026071509264313800_bib41","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S2213-8587(24)00316-4","article-title":"Definition and diagnostic criteria of clinical obesity","volume":"13","author":"Rubino","year":"2025","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2026071509264313800_bib42","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.49124","article-title":"Body mass index and anthropometric criteria to assess obesity","volume":"8","author":"Al-Roub","year":"2025","journal-title":"JAMA Netw Open"},{"key":"2026071509264313800_bib43","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0333402","article-title":"Assessing metabolic health in a general population: a comparative analysis of three definitions in the Troms\u00f8 study 2015\u20132016","volume":"20","author":"Machlik","year":"2025","journal-title":"PLoS One"},{"key":"2026071509264313800_bib44","doi-asserted-by":"crossref","first-page":"867","DOI":"10.4093\/dmj.2018.0130","article-title":"The relationship between thyroid function and different obesity phenotypes in Korean euthyroid adults","volume":"43","author":"Kim","year":"2019","journal-title":"Diabetes Metab J"},{"key":"2026071509264313800_bib45","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2023.1158013","article-title":"Association between different metabolic phenotypes of obesity and thyroid disorders among Chinese adults: a nationwide cross-sectional study","volume":"14","author":"Song","year":"2023","journal-title":"Front Endocrinol"},{"key":"2026071509264313800_bib46","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1186\/s40001-023-01135-1","article-title":"Association between thyroid function and obesity phenotypes in healthy euthyroid individuals: an investigation based on Tehran thyroid study","volume":"28","author":"Abiri","year":"2023","journal-title":"Eur J Med Res"},{"key":"2026071509264313800_bib47","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1530\/eje.0.1380030","article-title":"Ultrasonography in the evaluation of cold thyroid nodules","volume":"138","author":"Heged\u00fcs","year":"1998","journal-title":"Eur J Endocrinol"},{"key":"2026071509264313800_bib48","article-title":"The relationship between ultrasound findings and thyroid function in children and adolescent autoimmune diffuse thyroid diseases","volume":"11","author":"Park","year":"2021","journal-title":"Sci Rep"},{"key":"2026071509264313800_bib49","doi-asserted-by":"crossref","first-page":"4749","DOI":"10.1210\/jc.2008-0823","article-title":"Thyroid function and structure are affected in childhood obesity","volume":"93","author":"Radetti","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib50","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1007\/s40618-021-01662-w","article-title":"Histological pattern and gene expression profiling of thyroid tissue in subjects with obesity","volume":"45","author":"Basolo","year":"2022","journal-title":"J Endocrinol Investig"},{"key":"2026071509264313800_bib51","doi-asserted-by":"crossref","first-page":"2757","DOI":"10.1210\/jc.2018-02399","article-title":"Altered thyroid function and structure in children and adolescents who are overweight and obese: reversal after weight loss","volume":"104","author":"Licenziati","year":"2019","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib52","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1159\/000509786","article-title":"Thyroid volume and thyroid function parameters are independently associated with weight status in overweight children","volume":"93","author":"Lass","year":"2020","journal-title":"Horm Res Paediatr"},{"key":"2026071509264313800_bib53","article-title":"Technical challenges of imaging & image-guided interventions in obese patients","volume":"91","author":"Uppot","year":"2018","journal-title":"Br J Radiol"},{"key":"2026071509264313800_bib54","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1080\/07435800.2019.1625056","article-title":"Thyroid nodules in severely obese patients: frequency and risk of malignancy on ultrasonography","volume":"45","author":"de Siqueira","year":"2020","journal-title":"Endocr Res"},{"key":"2026071509264313800_bib55","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1001\/jama.2023.19897","article-title":"Obesity management in adults: a review","volume":"330","author":"Elmaleh-Sachs","year":"2023","journal-title":"JAMA"},{"key":"2026071509264313800_bib56","doi-asserted-by":"crossref","first-page":"2985","DOI":"10.1016\/j.jacc.2013.11.004","article-title":"2013 AHA\/ACC\/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and the Obesity Society","volume":"63","author":"Jensen","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"2026071509264313800_bib57","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1159\/000496183","article-title":"European practical and patient-centred guidelines for adult obesity management in primary care","volume":"12","author":"Durrer Schutz","year":"2019","journal-title":"Obes Facts"},{"key":"2026071509264313800_bib58","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1111\/j.1753-4887.1990.tb02909.x","article-title":"Restrained eating and human obesity","volume":"48","author":"Stunkard","year":"1990","journal-title":"Nutr Rev"},{"key":"2026071509264313800_bib59","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1038\/ijo.2017.28","article-title":"Thyroid hormones and changes in body weight and metabolic parameters in response to weight loss diets: the POUNDS LOST trial","volume":"41","author":"Liu","year":"2017","journal-title":"Int J Obes"},{"key":"2026071509264313800_bib60","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1007\/s40519-020-01043-x","article-title":"Basal and longitudinal changes in serum levels of TSH in morbid obese patients experiencing failure or success of dietary treatment","volume":"26","author":"Croce","year":"2021","journal-title":"Eat Weight Disord"},{"key":"2026071509264313800_bib61","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0269440","article-title":"Could the ketogenic diet induce a shift in thyroid function and support a metabolic advantage in healthy participants? A pilot randomized-controlled-crossover trial","volume":"17","author":"Iacovides","year":"2022","journal-title":"PLoS One"},{"key":"2026071509264313800_bib62","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1515\/jpem-2016-0281","article-title":"Changes of thyroid hormonal status in patients receiving ketogenic diet due to intractable epilepsy","volume":"30","author":"Kose","year":"2017","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2026071509264313800_bib63","doi-asserted-by":"crossref","first-page":"3953","DOI":"10.3390\/nu15183953","article-title":"Autoimmune thyroid disorders: the mediterranean diet as a protective choice","volume":"15","author":"Ruggeri","year":"2023","journal-title":"Nutrients"},{"key":"2026071509264313800_bib64","doi-asserted-by":"crossref","DOI":"10.3390\/nu12103173","article-title":"Adherence to a mediterranean diet and thyroid function in obesity: a cross-sectional Apulian survey","volume":"12","author":"Zupo","year":"2020","journal-title":"Nutrients"},{"key":"2026071509264313800_bib65","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1038\/oby.2009.320","article-title":"Weight loss through gastric banding: effects on TSH and thyroid hormones in obese subjects with normal thyroid function","volume":"18","author":"Dall\u2019Asta","year":"2010","journal-title":"Obesity"},{"key":"2026071509264313800_bib66","doi-asserted-by":"crossref","first-page":"4077","DOI":"10.2147\/DMSO.S277486","article-title":"Laparoscopic sleeve gastrectomy-induced decreases in FT3 and TSH are related to fasting C-peptide in euthyroid patients with obesity","volume":"13","author":"Chen","year":"2020","journal-title":"Diabetes Metab Syndr Obes"},{"key":"2026071509264313800_bib67","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1007\/s11605-023-05662-4","article-title":"The impact of laparoscopic sleeve gastrectomy on thyroid functions in Egyptian patients with obesity","volume":"27","author":"Kamal","year":"2023","journal-title":"J Gastrointest Surg"},{"key":"2026071509264313800_bib68","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1159\/000499385","article-title":"Decreased leptin is associated with alterations in thyroid-stimulating hormone levels after Roux-en-Y gastric bypass surgery in obese euthyroid patients with type 2 diabetes","volume":"12","author":"Yu","year":"2019","journal-title":"Obes Facts"},{"key":"2026071509264313800_bib69","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s11695-013-1150-5","article-title":"Evolution of subclinical hypothyroidism and its relation with glucose and triglycerides levels in morbidly obese patients after undergoing sleeve gastrectomy as bariatric procedure","volume":"24","author":"Ruiz-Tovar","year":"2014","journal-title":"Obes Surg"},{"key":"2026071509264313800_bib70","doi-asserted-by":"crossref","first-page":"3292","DOI":"10.1007\/s11695-017-2965-2","article-title":"Effect of bariatric surgery on thyroid function in obese patients: a systematic review and meta-analysis","volume":"27","author":"Guan","year":"2017","journal-title":"Obes Surg"},{"key":"2026071509264313800_bib71","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2024.1333033","article-title":"Total weight loss induces the alteration in thyroid function after bariatric surgery","volume":"15","author":"Tian","year":"2024","journal-title":"Front Endocrinol"},{"key":"2026071509264313800_bib72","doi-asserted-by":"crossref","first-page":"5579","DOI":"10.1007\/s11695-025-08390-7","article-title":"Thyroid function post-bariatric surgery: an updated systematic review and meta-analysis","volume":"35","author":"Seighali","year":"2025","journal-title":"Obes Surg"},{"key":"2026071509264313800_bib73","doi-asserted-by":"crossref","first-page":"4808","DOI":"10.1007\/s11695-021-05646-w","article-title":"Effect of laparoscopic sleeve gastrectomy vs OAGB on thyroid function tests in patients with morbid obesity and subclinical or clinical hypothyroidism","volume":"31","author":"Najjari","year":"2021","journal-title":"Obes Surg"},{"key":"2026071509264313800_bib74","doi-asserted-by":"crossref","first-page":"4142","DOI":"10.1007\/s11695-025-08109-8","article-title":"Does bariatric surgery impact hypothyroidism and vice versa? Results of a prospective comparative study","volume":"35","author":"Misra","year":"2025","journal-title":"Obes Surg"},{"key":"2026071509264313800_bib75","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.soard.2019.01.001","article-title":"Oral levothyroxine therapy postbariatric surgery: biopharmaceutical aspects and clinical effects","volume":"15","author":"Azran","year":"2019","journal-title":"Surg Obes Relat Dis"},{"key":"2026071509264313800_bib76","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s12020-022-03289-0","article-title":"The performance of levothyroxine tablet is impaired by bariatric surgery","volume":"80","author":"Trimboli","year":"2023","journal-title":"Endocrine"},{"key":"2026071509264313800_bib77","doi-asserted-by":"crossref","first-page":"R200","DOI":"10.1530\/EC-21-0130","article-title":"How glucagon-like peptide 1 receptor agonists work","volume":"10","author":"Andreasen","year":"2021","journal-title":"Endocr Connect"},{"key":"2026071509264313800_bib78","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0332091","article-title":"Weight and body composition outcomes with liraglutide in individuals with well-treated hypothyroidism: a retrospective case-control study","volume":"20","author":"Chukir","year":"2025","journal-title":"PLoS One"},{"key":"2026071509264313800_bib79","doi-asserted-by":"crossref","first-page":"687","DOI":"10.3390\/biom14060687","article-title":"Implications of GLP-1 receptor agonist on thyroid function: a literature review of its effects on thyroid volume, risk of cancer, functionality and TSH levels","volume":"14","author":"Capuccio","year":"2024","journal-title":"Biomolecules"},{"key":"2026071509264313800_bib80","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1007\/s00125-016-3874-y","article-title":"GLP-1 receptors exist in the parietal cortex, hypothalamus and medulla of human brains and the GLP-1 analogue liraglutide alters brain activity related to highly desirable food cues in individuals with diabetes: a crossover, randomised, placebo-controlled trial","volume":"59","author":"Farr","year":"2016","journal-title":"Diabetologia"},{"key":"2026071509264313800_bib81","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1089\/thy.2023.0284","article-title":"GLP-1 receptor signaling has different effects on the perikarya and axons of the hypophysiotropic thyrotropin-releasing hormone synthesizing neurons in Male mice","volume":"34","author":"Ruska","year":"2024","journal-title":"Thyroid"},{"key":"2026071509264313800_bib82","doi-asserted-by":"crossref","first-page":"4130","DOI":"10.1210\/endo.137.10.8828468","article-title":"Glucagon-like peptide-1 (GLP-1) releases thyrotropin (TSH): characterization of binding sites for GLP-1 on alpha-TSH cells","volume":"137","author":"Beak","year":"1996","journal-title":"Endocrinology"},{"key":"2026071509264313800_bib83","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1210\/jc.2011-2407","article-title":"Glucagon like peptide-1 receptor expression in the human thyroid gland","volume":"97","author":"Gier","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"2026071509264313800_bib84","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1159\/000501895","article-title":"The effect of exenatide on thyroid-stimulating hormone and thyroid volume","volume":"8","author":"Sencar","year":"2019","journal-title":"Eur Thyroid J"},{"key":"2026071509264313800_bib85","first-page":"275","article-title":"Exenatide treatment reduces thyroid gland volume, but has no effect on the size of thyroid nodules","volume":"16","author":"K\u00f6seo\u011flu","year":"2020","journal-title":"Acta Endocrinol"},{"key":"2026071509264313800_bib86","doi-asserted-by":"crossref","DOI":"10.1155\/2022\/1786559","article-title":"Effect of liraglutide on serum TSH levels in patients with NAFLD and its underlying mechanisms","volume":"2022","author":"Ye","year":"2022","journal-title":"Int J Clin Pract"},{"key":"2026071509264313800_bib87","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/cen.14901","article-title":"The GLP-1 receptor agonist exenatide reduces serum TSH by its effect on body weight in people with type 2 diabetes","volume":"99","author":"Tee","year":"2023","journal-title":"Clin Endocrinol"},{"key":"2026071509264313800_bib88","doi-asserted-by":"crossref","DOI":"10.1002\/cph4.70083","article-title":"Advantage of semaglutide: comprehensive analysis of metabolic impact of semaglutide-treated and pair-fed rats","volume":"15","author":"Byun","year":"2025","journal-title":"Compr Physiol"},{"key":"2026071509264313800_bib89","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.eprac.2025.07.013","article-title":"Implications of glucagon-like peptide-1 receptor agonists on thyroid function and thyroid nodules: a drug target mendelian randomization and cohort study","volume":"32","author":"Zhang","year":"2026","journal-title":"Endocr Pract"},{"key":"2026071509264313800_bib90","doi-asserted-by":"crossref","first-page":"216","DOI":"10.7326\/ANNALS-25-02237","article-title":"Risk for cancer with glucagon-like peptide-1 receptor agonists and dual agonists: a systematic review and meta-analysis","volume":"179","author":"Ko","year":"2026","journal-title":"Ann Intern Med"},{"key":"2026071509264313800_bib91","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.70104","article-title":"Long-term glucagon-like peptide 1 receptor agonist use is not associated with increased risk of thyroid cancer in adults with type 2 diabetes","volume":"41","author":"Pollack","year":"2025","journal-title":"Diabetes Metab Res Rev"},{"key":"2026071509264313800_bib92","doi-asserted-by":"crossref","DOI":"10.3389\/fphar.2023.1303844","article-title":"Drug repositioning in thyroid cancer treatment: the intriguing case of anti-diabetic drugs","volume":"14","author":"Greco","year":"2023","journal-title":"Front Pharmacol"},{"key":"2026071509264313800_bib93","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.927859","article-title":"Use of GLP-1 receptor agonists and occurrence of thyroid disorders: a meta-analysis of randomized controlled trials","volume":"13","author":"Hu","year":"2022","journal-title":"Front Endocrinol"}],"container-title":["European Thyroid Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/etj.bioscientifica.com\/view\/journals\/etj\/aop\/ETJ-26-0082\/ETJ-26-0082.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/etj.bioscientifica.com\/downloadpdf\/journals\/etj\/aop\/ETJ-26-0082\/ETJ-26-0082.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/doi\/10.1530\/ETJ-26-0082\/519732\/etj-26-0082.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article-pdf\/doi\/10.1530\/ETJ-26-0082\/519732\/etj-26-0082.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:27:02Z","timestamp":1784122022000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/etj\/article\/15\/4\/ETJ260082\/77530\/Obesity-related-thyroid-reflections-from-weight"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,24]]},"references-count":93,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,8,1]]}},"URL":"https:\/\/doi.org\/10.1530\/etj-26-0082","relation":{},"ISSN":["2235-0802"],"issn-type":[{"value":"2235-0802","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,24]]},"article-number":"ETJ260082"}}