{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T19:08:07Z","timestamp":1791832087471,"version":"4.3.4"},"reference-count":180,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CIMB"],"abstract":"<jats:p>Obesity is a multifactorial chronic disease resulting from complex genetic, molecular, environmental, and behavioral interactions. Its prevalence rises worldwide, affecting cardiovascular, metabolic, oncological, hepatic, respiratory, and skeletal health. Beyond caloric excess, genetic predisposition, epigenetic modifications, gut microbiota dysbiosis, endocrine-disrupting agents, circadian misalignment, and intergenerational and prenatal influences are critical determinants of obesity risk. Core pathophysiological mechanisms include insulin resistance, dyslipidemia, chronic low-grade inflammation, and neuroendocrine dysregulation of appetite and energy balance. These processes are linked to comorbidities such as type 2 diabetes, hypertension, atherosclerosis, fatty liver disease, sleep apnea, osteoporosis, and cancer. Advances in molecular profiling, metabolic phenotyping, and body composition analysis are refining obesity classification and enabling precise risk stratification. Current therapeutic strategies include behavioral interventions addressing stress-related mechanisms, pharmacological therapies such as GLP-1 receptor agonists, emerging gene therapy approaches, and bariatric surgery. Gut-derived hormones (leptin, ghrelin, GLP-1, PYY, CCK) are recognized as pivotal regulators of appetite and weight. Preventive strategies increasingly emphasize circadian alignment, while epigenetic inheritance and prenatal exposures such as maternal obesity or smoking highlight early-life programming in future metabolic health. Additionally, artificial intelligence-based platforms and personalized nutrition provide innovative opportunities for individualized prevention and management. This review synthesizes contemporary evidence on the biological basis, systemic consequences, preventive strategies, and evolving therapeutic modalities of obesity, affirming its recognition as a complex chronic disease requiring personalized, multidisciplinary care.<\/jats:p>","DOI":"10.3390\/cimb47100787","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T08:09:42Z","timestamp":1758614982000},"page":"787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["Obesity as a Multifactorial Chronic Disease: Molecular Mechanisms, Systemic Impact, and Emerging Digital Interventions"],"prefix":"10.3390","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6799-4746","authenticated-orcid":false,"given":"Ewelina","family":"M\u0142ynarska","sequence":"first","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1234-3409","authenticated-orcid":false,"given":"Kinga","family":"Bojdo","sequence":"additional","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Bulicz","sequence":"additional","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Frankenstein","sequence":"additional","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6921-2730","authenticated-orcid":false,"given":"Magdalena","family":"G\u0105sior","sequence":"additional","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6075-9627","authenticated-orcid":false,"given":"Natalia","family":"Kustosik","sequence":"additional","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Rysz","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hypertension and Internal Medicine, Medical University of Lodz, 90-549 \u0141odz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Franczyk","sequence":"additional","affiliation":[{"name":"Department of Nephrocardiology, Medical University of Lodz, 90-419 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/ijmr.IJMR_1768_17","article-title":"Obesity subtypes, related biomarkers & heterogeneity","volume":"151","author":"Mayoral","year":"2020","journal-title":"Indian J. Med. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1002\/oby.22727","article-title":"Proposal for a Scientifically Correct and Medically Actionable Disease Classification System (ICD) for Obesity","volume":"28","author":"Garvey","year":"2020","journal-title":"Obes. Silver Spring Md."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1159\/000497124","article-title":"The ABCD of Obesity: An EASO Position Statement on a Diagnostic Term with Clinical and Scientific Implications","volume":"12","author":"Busetto","year":"2019","journal-title":"Obes. Facts"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1007\/s11154-023-09796-3","article-title":"Relevance of body composition in phenotyping the obesities","volume":"24","year":"2023","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_6","first-page":"e984","article-title":"Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association","volume":"143","author":"Poirier","year":"2021","journal-title":"Circulation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1026","DOI":"10.1093\/eurjpc\/zwae025","article-title":"Obesity and cardiovascular health","volume":"31","author":"Welsh","year":"2024","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_8","unstructured":"Khanna, D., Welch, B.S., and Rehman, A. (2025). Pathophysiology of Obesity, StatPearls [Internet], Available online: http:\/\/www.ncbi.nlm.nih.gov\/books\/NBK572076\/."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Konwerski, M., G\u0105secka, A., Opolski, G., Grabowski, M., and Mazurek, T. (2022). Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review. Biology, 11.","DOI":"10.3390\/biology11030355"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.21037\/gs.2019.12.03","article-title":"Obesity-related hypertension: A review of pathophysiology, management, and the role of metabolic surgery","volume":"9","author":"Shariq","year":"2020","journal-title":"Gland. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1161\/CIRCRESAHA.116.305697","article-title":"Obesity-induced hypertension: Interaction of neurohumoral and renal mechanisms","volume":"116","author":"Hall","year":"2015","journal-title":"Circ. Res."},{"key":"ref_12","unstructured":"Wickramasinghe, M., and Weaver, J.U. (2018). Practical Guide to Obesity, Elsevier."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1001\/jamacardio.2019.3780","article-title":"Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review","volume":"4","author":"Sniderman","year":"2019","journal-title":"JAMA Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.tcm.2015.10.004","article-title":"Metabolic syndrome update","volume":"26","author":"Grundy","year":"2016","journal-title":"Trends Cardiovasc. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/978-3-319-48382-5_15","article-title":"Endothelial Dysfunction in Obesity","volume":"960","author":"Engin","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1001\/jamacardio.2019.3593","article-title":"Temporal Trends and Patterns in Mortality After Incident Heart Failure: A Longitudinal Analysis of 86 000 Individuals","volume":"4","author":"Conrad","year":"2019","journal-title":"JAMA Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.jchf.2018.09.006","article-title":"Physical Activity, Fitness, and Obesity in Heart Failure with Preserved Ejection Fraction","volume":"6","author":"Pandey","year":"2018","journal-title":"JACC Heart Fail."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1161\/CIRCULATIONAHA.115.016801","article-title":"Body Mass Index, Abdominal Fatness, and Heart Failure Incidence and Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies","volume":"133","author":"Aune","year":"2016","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"44","DOI":"10.14797\/mdcvj.1511","article-title":"The Impact of Obesity on Cardiovascular Diseases: Heart Failure","volume":"21","author":"Alansari","year":"2025","journal-title":"Methodist DeBakey Cardiovasc. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jacc.2017.11.011","article-title":"Obesity: Pathophysiology and Management","volume":"71","author":"Gadde","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ahmed, B., Sultana, R., and Greene, M.W. (2021). Adipose tissue and insulin resistance in obese. Biomed. Pharmacother., 137.","DOI":"10.1016\/j.biopha.2021.111315"},{"key":"ref_22","unstructured":"Freeman, A.M., and Pennings, N. (2023). Insulin Resistance, StatPearls Publishing."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/MOL.0b013e3283346ccc","article-title":"The distinction of metabolically \u2018healthy\u2019 from \u2018unhealthy\u2019 obese individuals","volume":"21","year":"2010","journal-title":"Curr. Opin. Lipidol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Szukiewicz, D. (2023). Molecular Mechanisms for the Vicious Cycle between Insulin Resistance and the Inflammatory Response in Obesity. Int. J. Mol. Sci., 24.","DOI":"10.20944\/preprints202305.1026.v1"},{"key":"ref_25","unstructured":"International Diabetes Federation (IDF) (2022). IDF Diabetes Atlas, International Diabetes Federation (IDF). [10th ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1056\/NEJMoa1610187","article-title":"Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002\u20132012","volume":"376","author":"Lawrence","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"American Diabetes Association (2021). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2019. Diabetes Care, 44, S15\u2013S33.","DOI":"10.2337\/dc21-S002"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1038\/s41574-020-0355-7","article-title":"Pancreatic \u03b2-cells in type 1 and type 2 diabetes mellitus: Different pathways to failure","volume":"16","author":"Eizirik","year":"2020","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2022). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care., 45, S17\u2013S38.","DOI":"10.2337\/dc22-S002"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Ruze, R., Liu, T., Zou, X., Song, J., Chen, Y., Xu, R., Yin, X., and Xu, Q. (2023). Obesity and type 2 diabetes mellitus: Connections in epidemiology, pathogenesis, and treatments. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1161521"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s13679-023-00518-z","article-title":"Obesity and Dyslipidemia: A Review of Current Evidence","volume":"12","author":"Vekic","year":"2023","journal-title":"Curr. Obes. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.3390\/nu5041218","article-title":"Dyslipidemia in obesity: Mechanisms and potential targets","volume":"5","author":"Klop","year":"2013","journal-title":"Nutrients"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zheng, C., Liu, Y., Xu, C., Zeng, S., Wang, Q., Guo, Y., Li, J., Li, S., Dong, M., and Luo, X. (2024). Association between obesity and the prevalence of dyslipidemia in middle-aged and older people: An observational study. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-62892-5"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1016\/j.metabol.2018.11.005","article-title":"Obesity and dyslipidemia","volume":"92","author":"Vekic","year":"2019","journal-title":"Metabolism"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"100108","DOI":"10.1016\/j.obpill.2024.100108","article-title":"Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024","volume":"10","author":"Bays","year":"2024","journal-title":"Obes. Pillars"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Scully, T., Ettela, A., LeRoith, D., and Gallagher, E.J. (2020). Obesity, Type 2 Diabetes, and Cancer Risk. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.615375"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1007\/s10555-022-10061-3","article-title":"Obesity, cancer risk, and time-restricted eating","volume":"41","author":"Das","year":"2022","journal-title":"Cancer Metastasis Rev."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e000647","DOI":"10.20945\/2359-3997000000647","article-title":"Obesity, diabetes, and cancer: Epidemiology, pathophysiology, and potential interventions","volume":"67","author":"Wayerbacher","year":"2023","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.metabol.2018.11.001","article-title":"Obesity and cancer risk: Emerging biological mechanisms and perspectives","volume":"92","author":"Avgerinos","year":"2019","journal-title":"Metabolism"},{"key":"ref_40","unstructured":"World Cancer Research Fund\/American Institute for Cancer Research Continuous Update Project Expert Report Body Fatness and Weight Gain and the Risk of Cancer. Available online: https:\/\/www.wcrf.org\/wp-content\/uploads\/2024\/11\/Summary-of-Third-Expert-Report-2018.pdf."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"3990","DOI":"10.1172\/JCI129187","article-title":"Altered adipose tissue and adipocyte function in the pathogenesis of metabolic syndrome","volume":"129","author":"Kahn","year":"2019","journal-title":"J. Clin. Investig."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"799","DOI":"10.4093\/dmj.2021.0077","article-title":"Obesity, Diabetes, and Increased Cancer Progression","volume":"45","author":"Kim","year":"2021","journal-title":"Diabetes Metab. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1002\/j.2040-4603.2018.tb00006.x","article-title":"Contribution of Adipose Tissue to Development of Cancer","volume":"8","author":"Cozzo","year":"2017","journal-title":"Compr. Physiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1038\/nrendo.2014.94","article-title":"Obesity and cancer--mechanisms underlying tumour progression and recurrence","volume":"10","author":"Park","year":"2014","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s13045-019-0778-6","article-title":"Cancer-associated adipocytes: Key players in breast cancer progression","volume":"12","author":"Wu","year":"2019","journal-title":"J. Hematol. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: A literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/S0140-6736(13)60734-5","article-title":"Adult obstructive sleep apnoea","volume":"383","author":"Jordan","year":"2014","journal-title":"Lancet Lond. Engl."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1378\/chest.09-0360","article-title":"Interactions between obesity and obstructive sleep apnea: Implications for treatment","volume":"137","author":"Caples","year":"2010","journal-title":"Chest"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1513\/pats.200708-137MG","article-title":"Obesity and obstructive sleep apnea: Pathogenic mechanisms and therapeutic approaches","volume":"5","author":"Schwartz","year":"2008","journal-title":"Proc. Am. Thorac. Soc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11892-023-01510-6","article-title":"Sleep Apnea, Obesity, and Diabetes\u2014An Intertwined Trio","volume":"23","author":"Kurnool","year":"2023","journal-title":"Curr. Diabetes Rep."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/S2468-1253(22)00062-0","article-title":"Global multi-stakeholder endorsement of the MAFLD definition","volume":"7","author":"Bugianesi","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1002\/ueg2.12302","article-title":"Burden of obesity in gastrointestinal and liver diseases","volume":"10","author":"Krznaric","year":"2022","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1093\/cvr\/cvad095","article-title":"Non-alcoholic fatty liver disease: Pathophysiological concepts and treatment options","volume":"119","author":"Grander","year":"2023","journal-title":"Cardiovasc. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1097\/COC.0000000000000388","article-title":"Obesity is Independently Associated with Increased Risk of Hepatocellular Cancer-related Mortality: A Systematic Review and Meta-Analysis","volume":"41","author":"Gupta","year":"2018","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1111\/apt.13341","article-title":"Increased risk of hepatocellular carcinoma in chronic hepatitis C patients with new onset diabetes: A nation-wide cohort study","volume":"42","author":"Huang","year":"2015","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.cgh.2016.10.012","article-title":"Infection with Hepatitis C Virus Genotype 3 Is an Independent Risk Factor for End-Stage Liver Disease, Hepatocellular Carcinoma, and Liver-Related Death","volume":"15","author":"McMahon","year":"2017","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1016\/j.amjmed.2011.06.013","article-title":"Obesity is not protective against fracture in postmenopausal women: GLOW","volume":"124","author":"Compston","year":"2011","journal-title":"Am. J. Med."},{"key":"ref_58","first-page":"372","article-title":"Obesity, osteoporosis and bone metabolism","volume":"20","author":"Gkastaris","year":"2020","journal-title":"J. Musculoskelet. Neuronal Interact."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1359\/jbmr.091015","article-title":"Growth hormone regulates the balance between bone formation and bone marrow adiposity","volume":"25","author":"Menagh","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s43465-023-01052-9","article-title":"Osteoporosis and Obesity","volume":"57","author":"Arjunan","year":"2023","journal-title":"Indian J. Orthop."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1002\/jbmr.107","article-title":"Adipose tissue and volumetric bone mineral density of older Afro-Caribbean men","volume":"25","author":"Miljkovic","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Sharma, D.K., Anderson, P.H., Morris, H.A., and Clifton, P.M. (2020). Visceral Fat Is a Negative Determinant of Bone Health in Obese Postmenopausal Women. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17113996"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/humupd\/dmw045","article-title":"Ovarian hormones and obesity","volume":"23","author":"Leeners","year":"2017","journal-title":"Hum. Reprod. Update"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1530\/JOE-16-0484","article-title":"Leptin stimulates bone formation in ob\/ob mice at doses having minimal impact on energy metabolism","volume":"232","author":"Philbrick","year":"2017","journal-title":"J. Endocrinol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.puhe.2019.11.001","article-title":"Association of obesity with bone mineral density and osteoporosis in adults: A systematic review and meta-analysis","volume":"180","author":"Qiao","year":"2020","journal-title":"Public Health"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.bone.2015.11.020","article-title":"Impact of obesity on bone mass throughout adult life: Influence of gender and severity of obesity","volume":"90","author":"Mura","year":"2016","journal-title":"Bone"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1375\/136905203770326411","article-title":"Sex differences in heritability of BMI: A comparative study of results from twin studies in eight countries","volume":"6","author":"Schousboe","year":"2003","journal-title":"Twin Res. Hum. Genet."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1186\/s13098-022-00947-1","article-title":"Recent progress in epigenetics of obesity","volume":"14","author":"Wu","year":"2022","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1007\/s13679-023-00526-z","article-title":"Genetics and Epigenetics in Obesity: What Do We Know so Far?","volume":"12","author":"Keller","year":"2023","journal-title":"Curr. Obes. Rep."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Zhang, Q., Xiao, X., Zheng, J., Li, M., Yu, M., Ping, F., Wang, T., and Wang, X. (2021). Maternal High-Fat Diet Disturbs the DNA Methylation Profile in the Brown Adipose Tissue of Offspring Mice. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.705827"},{"key":"ref_71","first-page":"379","article-title":"Genetic and epigenetic causes of obesity","volume":"28","author":"Thaker","year":"2017","journal-title":"Adolesc. Med. State Art Rev."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"van Uhm, J., van Rossum, E.F.C., van Haelst, M.M., Jansen, P.R., and van den Akker, E.L. (2025). Polygenic Childhood Obesity: Integrating Genetics and Environment for Early Intervention. Horm. Res. Paediatr., Online ahead of print.","DOI":"10.1159\/000546951"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"101206","DOI":"10.1016\/j.molmet.2021.101206","article-title":"The melanocortin pathway and energy homeostasis: From discovery to obesity therapy","volume":"48","author":"Yeo","year":"2021","journal-title":"Mol. Metab."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1038\/s41576-021-00414-z","article-title":"The genetics of obesity: From discovery to biology","volume":"23","author":"Loos","year":"2022","journal-title":"Nat. Rev. Genet."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Chiurazzi, M., Cozzolino, M., Orsini, R.C., Di Maro, M., Di Minno, M.N.D., and Colantuoni, A. (2020). Impact of Genetic Variations and Epigenetic Mechanisms on the Risk of Obesity. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21239035"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1126\/science.1141634","article-title":"A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity","volume":"316","author":"Frayling","year":"2007","journal-title":"Science"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s40348-014-0003-1","article-title":"Monogenic forms of childhood obesity due to mutations in the leptin gene","volume":"1","author":"Funcke","year":"2014","journal-title":"Mol. Cell Pediatr."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1017\/S0007114520000380","article-title":"Microbial dysbiosis-induced obesity: Role of gut microbiota in homoeostasis of energy metabolism","volume":"123","author":"Amabebe","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.physbeh.2007.04.011","article-title":"Stress, eating and the reward system","volume":"91","author":"Adam","year":"2007","journal-title":"Physiol. Behav."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"15","DOI":"10.4093\/dmj.2021.0280","article-title":"Insulin Resistance: From Mechanisms to Therapeutic Strategies","volume":"46","author":"Lee","year":"2022","journal-title":"Diabetes Metab. J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"110691","DOI":"10.1016\/j.diabres.2023.110691","article-title":"Association between obesity, inflammation and insulin resistance: Insights into signaling pathways and therapeutic interventions","volume":"200","author":"Kushwaha","year":"2023","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1038\/nrendo.2015.163","article-title":"Endocrine disruptors and obesity","volume":"11","author":"Heindel","year":"2015","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"bqaa024","DOI":"10.1210\/endocr\/bqaa024","article-title":"Environmental Obesogens and Their Impact on Susceptibility to Obesity: New Mechanisms and Chemicals","volume":"161","author":"Egusquiza","year":"2020","journal-title":"Endocrinology"},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Mohajer, N., Du, C.Y., Checkcinco, C., and Blumberg, B. (2021). Obesogens: How They Are Identified and Molecular Mechanisms Underlying Their Action. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.780888"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1038\/s41366-024-01460-3","article-title":"Obesogens: A unifying theory for the global rise in obesity","volume":"48","author":"Heindel","year":"2024","journal-title":"Int. J. Obes."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"123391","DOI":"10.1016\/j.envpol.2024.123391","article-title":"The association between prenatal exposure to bisphenol A and offspring obesity: A systematic review","volume":"344","author":"Guo","year":"2024","journal-title":"Environ. Pollut."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"100381","DOI":"10.1016\/j.metop.2025.100381","article-title":"High-fat diet may increase the risk of insulin resistance by inducing dysbiosis","volume":"27","author":"Abbasi","year":"2025","journal-title":"Metab. Open"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1007\/s11906-020-01125-2","article-title":"Gut Microbiota-Derived Short-Chain Fatty Acids Facilitate Microbiota: Host Cross talk and Modulate Obesity and Hypertension","volume":"23","author":"Overby","year":"2021","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"135","DOI":"10.12938\/bmfh.17-010","article-title":"Gut microbial metabolite short-chain fatty acids and obesity","volume":"36","author":"Li","year":"2017","journal-title":"Biosci. Microbiota Food Health"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1152\/physrev.00063.2017","article-title":"Mechanisms of Insulin Action and Insulin Resistance","volume":"98","author":"Petersen","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1172\/JCI77812","article-title":"The pathogenesis of insulin resistance: Integrating signaling pathways and substrate flux","volume":"126","author":"Samuel","year":"2016","journal-title":"J. Clin. Investig."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1038\/s41392-022-01073-0","article-title":"Trends in insulin resistance: Insights into mechanisms and therapeutic strategy","volume":"7","author":"Li","year":"2022","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.cmet.2008.04.005","article-title":"IRS1-independent defects define major nodes of insulin resistance","volume":"7","author":"Hoehn","year":"2008","journal-title":"Cell Metab."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Cignarelli, A., Genchi, V.A., Perrini, S., Natalicchio, A., Laviola, L., and Giorgino, F. (2019). Insulin and Insulin Receptors in Adipose Tissue Development. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20030759"},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Chiefari, E., Mirabelli, M., La Vignera, S., Tanyola\u00e7, S., Foti, D.P., Aversa, A., and Brunetti, A. (2021). Insulin Resistance and Cancer: In Search for a Causal Link. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222011137"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.1038\/s12276-023-01006-z","article-title":"Nutrient sensors and their crosstalk","volume":"55","author":"Sung","year":"2023","journal-title":"Exp. Mol. Med."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1111\/j.1463-1326.2010.01275.x","article-title":"Hepatic steatosis: A role for de novo lipogenesis and the transcription factor SREBP-1c","volume":"12","author":"Foufelle","year":"2010","journal-title":"Diabetes Obes. Metab."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e12294","DOI":"10.1016\/j.heliyon.2022.e12294","article-title":"Excessive gluconeogenesis causes the hepatic insulin resistance paradox and its sequelae","volume":"8","author":"Onyango","year":"2022","journal-title":"Heliyon"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"e218","DOI":"10.1038\/emm.2015.122","article-title":"Regulation of glucose metabolism from a liver-centric perspective","volume":"48","author":"Han","year":"2016","journal-title":"Exp. Mol. Med."},{"key":"ref_100","first-page":"e14607","article-title":"Mechanisms of muscle insulin resistance and the cross-talk with liver and adipose tissue","volume":"8","author":"Nayak","year":"2020","journal-title":"Physiol. Rep."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1016\/j.nut.2007.08.008","article-title":"Relationship between stress, eating behavior, and obesity","volume":"23","author":"Torres","year":"2007","journal-title":"Nutrition"},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Bouillon-Minois, J.B., Trousselard, M., Thivel, D., Benson, A.C., Schmidt, J., Moustafa, F., Bouvier, D., and Dutheil, F. (2021). Leptin as a Biomarker of Stress: A Systematic Review and Meta-Analysis. Nutrients, 13.","DOI":"10.3390\/nu13103350"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.tem.2009.10.004","article-title":"Stress-induced obesity and the emotional nervous system","volume":"21","author":"Dallman","year":"2010","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1037\/hea0000576","article-title":"Impact of cognitive-behavioral interventions on weight loss and psychological outcomes: A meta-analysis","volume":"37","author":"Jacob","year":"2018","journal-title":"Health Psychol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/cpp.2695","article-title":"The effectiveness of acceptance and commitment therapy upon weight management and psychological well-being of adults with overweight or obesity: A systematic review","volume":"29","author":"Iturbe","year":"2022","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1007\/s10880-023-10000-6","article-title":"Comparative Effectiveness of Cognitive Behavioral Therapy and Behavioral Therapy in Obesity: A Systematic Review and Network Meta-Analysis","volume":"32","author":"Cha","year":"2025","journal-title":"J. Clin. Psychol. Med. Settings"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s13679-025-00634-y","article-title":"Acceptance and Commitment Therapy for Obesity","volume":"14","author":"Schumacher","year":"2025","journal-title":"Curr. Obes. Rep."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1530\/EC-19-0461","article-title":"Mindfulness affects stress, ghrelin, and BMI of obese children: A clinical trial","volume":"9","year":"2020","journal-title":"Endocr. Connect."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"e13860","DOI":"10.1111\/obr.13860","article-title":"Effects of mindfulness-based interventions on obesogenic eating behaviors: A systematic review and meta-analysis","volume":"26","author":"Kao","year":"2025","journal-title":"Obes. Rev."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"651936","DOI":"10.1155\/2011\/651936","article-title":"Mindfulness Intervention for Stress Eating to Reduce Cortisol and Abdominal Fat among Overweight and Obese Women: An Exploratory Randomized Controlled Study","volume":"2011","author":"Daubenmier","year":"2011","journal-title":"J. Obes."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s11154-023-09808-2","article-title":"Individualised prescription of medications for treatment of obesity in adults","volume":"24","author":"Hocking","year":"2023","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/14728214.2021.1947240","article-title":"Emerging glucagon-like peptide 1 receptor agonists for the treatment of obesity","volume":"26","author":"Jepsen","year":"2021","journal-title":"Expert Opin. Emerg. Drugs"},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Wang, J.Y., Wang, Q.W., Yang, X.Y., Yang, W., Li, D.R., Jin, J.Y., Zhang, H.C., and Zhang, X.F. (2023). GLP-1 receptor agonists for the treatment of obesity: Role as a promising approach. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1085799"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.cmet.2018.03.001","article-title":"Mechanisms of Action and Therapeutic Application of Glucagon-like Peptide-1","volume":"27","author":"Drucker","year":"2018","journal-title":"Cell Metab."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1152\/physrev.00034.2006","article-title":"The physiology of glucagon-like peptide 1","volume":"87","author":"Holst","year":"2007","journal-title":"Physiol. Rev."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"3346","DOI":"10.2337\/db14-0302","article-title":"GLP-1 agonism stimulates brown adipose tissue thermogenesis and browning through hypothalamic AMPK","volume":"63","author":"Beiroa","year":"2014","journal-title":"Diabetes"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"E677","DOI":"10.1152\/ajpendo.00446.2012","article-title":"Central glucagon-like peptide 1 receptor-induced anorexia requires glucose metabolism-mediated suppression of AMPK and is impaired by central fructose","volume":"304","author":"Burmeister","year":"2013","journal-title":"Am. J. Physiol. Endocrinol. Metab."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1007\/s00125-016-3896-5","article-title":"GLP-1 receptor agonist promotes brown remodelling in mouse white adipose tissue through SIRT1","volume":"59","author":"Xu","year":"2016","journal-title":"Diabetologia"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"2825","DOI":"10.1093\/cvr\/cvac176","article-title":"New therapies for obesity","volume":"119","author":"Papamargaritis","year":"2024","journal-title":"Cardiovasc. Res."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1210\/endrev\/bnab034","article-title":"Novel Noninvasive Approaches to the Treatment of Obesity: From Pharmacotherapy to Gene Therapy","volume":"43","author":"Angelidi","year":"2022","journal-title":"Endocr. Rev."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1101\/gr.246900.118","article-title":"Targeted delivery of CRISPR interference system against Fabp4 to white adipocytes ameliorates obesity, inflammation, hepatic steatosis, and insulin resistance","volume":"29","author":"Chung","year":"2019","journal-title":"Genome Res."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"e8791","DOI":"10.15252\/emmm.201708791","article-title":"FGF21 gene therapy as treatment for obesity and insulin resistance","volume":"10","author":"Jimenez","year":"2018","journal-title":"EMBO Mol. Med."},{"key":"ref_123","first-page":"319","article-title":"Gene therapy for obesity: Progress and prospects","volume":"17","author":"Gao","year":"2014","journal-title":"Discov. Med."},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"Alhabeeb, H., AlFaiz, A., Kutbi, E., AlShahrani, D., Alsuhail, A., AlRajhi, S., Alotaibi, N., Alotaibi, K., AlAmri, S., and Alghamdi, S. (2021). Gut Hormones in Health and Obesity: The Upcoming Role of Short Chain Fatty Acids. Nutrients, 13.","DOI":"10.3390\/nu13020481"},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"171367","DOI":"10.1016\/j.peptides.2025.171367","article-title":"The role of leptin and ghrelin in the regulation of appetite in obesity","volume":"186","author":"Skoracka","year":"2025","journal-title":"Peptides"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1111\/j.1467-789X.2006.00270.x","article-title":"The role of leptin and ghrelin in the regulation of food intake and body weight in humans: A review","volume":"8","author":"Klok","year":"2007","journal-title":"Obes. Rev."},{"key":"ref_127","doi-asserted-by":"crossref","unstructured":"Izquierdo, A.G., Crujeiras, A.B., Casanueva, F.F., and Carreira, M.C. (2019). Leptin, Obesity, and Leptin Resistance: Where Are We 25 Years Later?. Nutrients, 11.","DOI":"10.3390\/nu11112704"},{"key":"ref_128","doi-asserted-by":"crossref","unstructured":"Obradovic, M., Sudar-Milovanovic, E., Soskic, S., Essack, M., Arya, S., Stewart, A.J., Gojobori, T., and Isenovic, E.R. (2021). Leptin and Obesity: Role and Clinical Implication. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.585887"},{"key":"ref_129","first-page":"90","article-title":"Ghrelin\u2014Physiological Functions and Regulation","volume":"11","year":"2015","journal-title":"Eur. Endocrinol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"e1243","DOI":"10.1002\/prp2.1243","article-title":"Novel Pharmaceuticals in Appetite Regulation: Exploring emerging gut peptides and their pharmacological prospects","volume":"12","author":"Kurtov","year":"2024","journal-title":"Pharmacol. Res. Perspect."},{"key":"ref_131","doi-asserted-by":"crossref","unstructured":"Popoviciu, M.S., P\u0103duraru, L., Yahya, G., Metwally, K., and Cavalu, S. (2023). Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241310449"},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/MED.0b013e32834eb77d","article-title":"Cholecystokinin","volume":"19","author":"Dockray","year":"2012","journal-title":"Curr. Opin. Endocrinol. Diabetes Obes."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.peptides.2017.09.007","article-title":"Cholecystokinin (CCK) and related adjunct peptide therapies for the treatment of obesity and type 2 diabetes","volume":"100","author":"Pathak","year":"2018","journal-title":"Peptides"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s13679-017-0276-5","article-title":"Potential Hormone Mechanisms of Bariatric Surgery","volume":"6","author":"Dimitriadis","year":"2017","journal-title":"Curr. Obes. Rep."},{"key":"ref_135","doi-asserted-by":"crossref","unstructured":"Ji, Y., Lee, H., Kaura, S., Yip, J., Sun, H., Guan, L., Han, W., and Ding, Y. (2021). Effect of Bariatric Surgery on Metabolic Diseases and Underlying Mechanisms. Biomolecules, 11.","DOI":"10.3390\/biom11111582"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.neuint.2019.04.010","article-title":"GLP-1, Molecular mechanisms and outcomes of a complex signaling system","volume":"128","author":"Smith","year":"2019","journal-title":"Neurochem. Int."},{"key":"ref_137","first-page":"1047","article-title":"Ghrelin and Obesity: Identifying Gaps and Dispelling Myths. A Reappraisal","volume":"31","author":"Makris","year":"2017","journal-title":"Vivo Athens"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.peptides.2015.08.013","article-title":"The effect of bariatric surgery on gastrointestinal and pancreatic peptide hormones","volume":"77","author":"Meek","year":"2016","journal-title":"Peptides"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1161\/HYPERTENSIONAHA.116.06588","article-title":"Keeping Up with the Clock: Circadian Disruption and Obesity Risk","volume":"68","author":"Covassin","year":"2016","journal-title":"Hypertens"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"e170998","DOI":"10.1172\/JCI170998","article-title":"Circadian disruption, clock genes, and metabolic health","volume":"134","author":"Schrader","year":"2024","journal-title":"J. Clin. Investig."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"bqaa180","DOI":"10.1210\/endocr\/bqaa180","article-title":"The Circadian Clock, Shift Work, and Tissue-Specific Insulin Resistance","volume":"161","author":"Oosterman","year":"2020","journal-title":"Endocrinology"},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"17302","DOI":"10.1073\/pnas.1412021111","article-title":"Impact of circadian misalignment on energy metabolism during simulated nightshift work","volume":"111","author":"McHill","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_143","doi-asserted-by":"crossref","unstructured":"Nogueira, L.F.R., Crispim, C.A., Cipolla-Neto, J., de Castro Moreno, C.R., and Marqueze, E.C. (2022). The Effect of Exogenous Melatonin on Eating Habits of Female Night Workers with Excessive Weight. Nutrients, 14.","DOI":"10.3390\/nu14163420"},{"key":"ref_144","doi-asserted-by":"crossref","unstructured":"Lam, C., and Chung, M.H. (2021). Dose-response effects of light therapy on sleepiness and circadian phase shift in shift workers: A meta-analysis and moderator analysis. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-89321-1"},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1097\/HJH.0000000000002848","article-title":"Light therapy improves diurnal blood pressure control in night shift workers via reduction of catecholamines: The EuRhythDia study","volume":"39","author":"Hannemann","year":"2021","journal-title":"J. Hypertens."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"S655","DOI":"10.1016\/j.dsx.2017.04.021","article-title":"Maternal and paternal periconceptional nutrition as an indicator of offspring metabolic syndrome risk in later life through epigenetic imprinting: A systematic review","volume":"11","author":"Dunford","year":"2017","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.tem.2020.02.009","article-title":"Epigenetic Transgenerational Inheritance of Obesity Susceptibility","volume":"31","author":"King","year":"2020","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1038\/s41580-018-0074-2","article-title":"Functions and mechanisms of epigenetic inheritance in animals","volume":"19","author":"Skvortsova","year":"2018","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"4200","DOI":"10.1210\/jc.2017-01155","article-title":"Low Vitamin B12 in Pregnancy Is Associated with Adipose-Derived Circulating miRs Targeting PPAR\u03b3 and Insulin Resistance","volume":"102","author":"Adaikalakoteswari","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0955-2863(01)00197-8","article-title":"Elevated plasma total homocysteine levels in hyperinsulinemic obese subjects","volume":"13","author":"Valle","year":"2002","journal-title":"J. Nutr. Biochem."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3177\/jnsv.59.367","article-title":"Transgenerational effects on the liver and pancreas resulting from maternal vitamin D restriction in mice","volume":"59","author":"Nascimento","year":"2013","journal-title":"J. Nutr. Sci. Vitaminol."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1093\/nutrit\/nuy034","article-title":"Adiposity, vitamin D requirements, and clinical implications for obesity-related metabolic abnormalities","volume":"76","author":"Boucher","year":"2018","journal-title":"Nutr. Rev."},{"key":"ref_153","doi-asserted-by":"crossref","unstructured":"Cechinel, L.R., Batabyal, R.A., Freishtat, R.J., and Zohn, I.E. (2022). Parental obesity-induced changes in developmental programming. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.918080"},{"key":"ref_154","doi-asserted-by":"crossref","unstructured":"Nakamura, A., Fran\u00e7ois, O., and Lepeule, J. (2021). Epigenetic Alterations of Maternal Tobacco Smoking during Pregnancy: A Narrative Review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18105083"},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1038\/382250a0","article-title":"Role of leptin in the neuroendocrine response to fasting","volume":"382","author":"Ahima","year":"1996","journal-title":"Nature"},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1210\/jcem-58-4-615","article-title":"Influence of cigarette smoking on goiter formation, thyroglobulin, and thyroid hormone levels in women","volume":"58","author":"Christensen","year":"1984","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1056\/NEJM199510123331503","article-title":"Impaired action of thyroid hormone associated with smoking in women with hypothyroidism","volume":"333","author":"Zulewski","year":"1995","journal-title":"N. Engl. J. Med."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1210\/jc.2003-030829","article-title":"Iodine nutrition in breast-fed infants is impaired by maternal smoking","volume":"89","author":"Laurberg","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1111\/j.1651-2227.1986.tb10287.x","article-title":"Smoking during pregnancy-effects on the fetal thyroid function","volume":"75","author":"Meberg","year":"1986","journal-title":"Acta Paediatr. Scand."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.lfs.2010.06.012","article-title":"Neonatal nicotine exposure alters leptin signaling in the hypothalamus-pituitary-thyroid axis in the late postnatal period and adulthood in rats","volume":"87","author":"Moura","year":"2010","journal-title":"Life Sci."},{"key":"ref_161","doi-asserted-by":"crossref","unstructured":"Che\u0142chowska, M., Gajewska, J., Ambroszkiewicz, J., Mazur, J., O\u0142tarzewski, M., and Maciejewski, T.M. (2021). Influence of Oxidative Stress Generated by Smoking during Pregnancy on Glutathione Status in Mother-Newborn Pairs. Antioxidants, 10.","DOI":"10.3390\/antiox10121866"},{"key":"ref_162","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1111\/j.1476-5381.2011.01488.x","article-title":"Maternal nicotine exposure and fetal programming of vascular oxidative stress in adult offspring","volume":"164","author":"Lim","year":"2011","journal-title":"Br. J. Pharmacol."},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"e53616","DOI":"10.2196\/53616","article-title":"Benefits and Risks of AI in Health Care: Narrative Review","volume":"13","author":"Chustecki","year":"2024","journal-title":"Interact. J. Med. Res."},{"key":"ref_164","doi-asserted-by":"crossref","unstructured":"Motevalli, M., Drenowatz, C., Tanous, D.R., Khan, N.A., and Wirnitzer, K. (2021). Management of Childhood Obesity-Time to Shift from Generalized to Personalized Intervention Strategies. Nutrients, 13.","DOI":"10.3390\/nu13041200"},{"key":"ref_165","doi-asserted-by":"crossref","unstructured":"Gonz\u00e1lez-Mart\u00edn, J.M., Torres-Mata, L.B., Cazorla-Rivero, S., Fern\u00e1ndez-Santana, C., G\u00f3mez-Bentolila, E., Clavo, B., and Rodr\u00edguez-Esparrag\u00f3n, F. (2023). An Artificial Intelligence Prediction Model of Insulin Sensitivity, Insulin Resistance, and Diabetes Using Genes Obtained through Differential Expression. Genes, 14.","DOI":"10.3390\/genes14122119"},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1186\/s12967-020-02658-5","article-title":"Precision medicine in the era of artificial intelligence: Implications in chronic disease management","volume":"18","author":"Subramanian","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_167","doi-asserted-by":"crossref","unstructured":"Couto Fda, F.S., and de Almeida, C.P.B. (2025). Mobile and Web Apps for Weight Management in Overweight and Obese Adults: An Updated Umbrella Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 22.","DOI":"10.3390\/ijerph22071152"},{"key":"ref_168","doi-asserted-by":"crossref","unstructured":"Agrawal, K., Goktas, P., Kumar, N., and Leung, M.F. (2025). Artificial intelligence in personalized nutrition and food manufacturing: A comprehensive review of methods, applications, and future directions. Front. Nutr., 12.","DOI":"10.3389\/fnut.2025.1636980"},{"key":"ref_169","doi-asserted-by":"crossref","unstructured":"Park, S.H., Choi, H.K., Park, J.H., and Hwang, J.T. (2024). Current insights into genome-based personalized nutrition technology: A patent review. Front. Nutr., 11.","DOI":"10.3389\/fnut.2024.1346144"},{"key":"ref_170","doi-asserted-by":"crossref","unstructured":"Gavai, A.K., and van Hillegersberg, J. (2025). AI-driven personalized nutrition: RAG-based digital health solution for obesity and type 2 diabetes. PLoS Digit. Health, 4.","DOI":"10.1371\/journal.pdig.0000758"},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.nutos.2024.06.001","article-title":"Personalized dietary recommendations for obese individuals\u2014A comparison of ChatGPT and the Food4Me algorithm","volume":"56","author":"Agne","year":"2024","journal-title":"Clin. Nutr. Open Sci."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.clnu.2025.03.003","article-title":"AI4Food, a feasibility study for the implementation of automated devices in the nutritional advice and follow up within a weight loss intervention","volume":"48","author":"Freixer","year":"2025","journal-title":"Clin. Nutr."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"e46036","DOI":"10.2196\/46036","article-title":"Effectiveness of an Artificial Intelligence-Assisted App for Improving Eating Behaviors: Mixed Methods Evaluation","volume":"26","author":"Chew","year":"2024","journal-title":"J. Med. Internet Res."},{"key":"ref_174","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1007\/s11695-024-07209-1","article-title":"Weight Loss with an AI-Powered Digital Platform for Lifestyle Intervention","volume":"34","author":"Khokhar","year":"2024","journal-title":"Obes. Surg."},{"key":"ref_175","first-page":"e46036","article-title":"A Novel AI-Driven Expert System for Obesity Diagnosis and Personalised Treatment","volume":"26","author":"Li","year":"2024","journal-title":"CAAI Trans. Intell. Technol."},{"key":"ref_176","doi-asserted-by":"crossref","unstructured":"Williamson, S.M., and Prybutok, V. (2024). Balancing Privacy and Progress: A Review of Privacy Challenges, Systemic Oversight, and Patient Perceptions in AI-Driven Healthcare. Appl. Sci., 14.","DOI":"10.3390\/app14020675"},{"key":"ref_177","doi-asserted-by":"crossref","first-page":"105780","DOI":"10.1016\/j.ijmedinf.2024.105780","article-title":"Towards Secure and Trusted AI in Healthcare: A Systematic Review of Emerging Innovations and Ethical Challenges","volume":"195","author":"Khan","year":"2025","journal-title":"Int. J. Med. Inform."},{"key":"ref_178","first-page":"e2249","article-title":"Artificial Intelligence in Medicine: Advantages and Disadvantages","volume":"8","author":"Sinha","year":"2024","journal-title":"Int. J. Surg. Open"},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"100138","DOI":"10.1016\/j.glmedi.2024.100138","article-title":"Artificial Intelligence and the Dehumanization of Patient Care","volume":"3","author":"Akingbola","year":"2024","journal-title":"J. Med. Surg. Public Health"},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1038\/s41746-025-01722-y","article-title":"Systematic review of cost effectiveness and budget impact of artificial intelligence in healthcare","volume":"8","year":"2025","journal-title":"Npj Digit. 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