{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:50:03Z","timestamp":1790347803172,"version":"4.1.0"},"reference-count":122,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The prevalence of obesity, a disorder linked to numerous comorbidities and metabolic complications, has recently increased dramatically worldwide and is highly prevalent in men, even at a young age. Compared to female patients, men with obesity more frequently have delayed diagnosis, higher severity of obesity, increased mortality rate, and only a minority of obese male patients are successfully treated, including with bariatric surgery. The aim of this review was to present the current state of knowledge about the clinical and therapeutic implications of obesity diagnosed in males.<\/jats:p>","DOI":"10.3390\/jcm12165354","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T10:47:02Z","timestamp":1692269222000},"page":"5354","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Clinical and Therapeutic Implications of Male Obesity"],"prefix":"10.3390","volume":"12","author":[{"given":"Monika","family":"Lenart-Lipi\u0144ska","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetology, and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6441-4224","authenticated-orcid":false,"given":"Micha\u0142","family":"\u0141uniewski","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology, and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3744-9058","authenticated-orcid":false,"given":"Joanna","family":"Szyde\u0142ko","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology, and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beata","family":"Matyjaszek-Matuszek","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology, and Metabolic Diseases, Medical University of Lublin, 20-954 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/obr.12551","article-title":"Obesity: A chronic relapsing progressive disease process. A position statement of the World Obesity Federation","volume":"18","author":"Bray","year":"2017","journal-title":"Obes. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"GBD 2015 Obesity Collaborators (2017). Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N. Engl. J. Med., 377, 13\u201327.","DOI":"10.1056\/NEJMoa1614362"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1016\/S0140-6736(14)60460-8","article-title":"Global, regional, and national prevalence of overweight and obesity in children and adults during 1980\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"384","author":"Ng","year":"2014","journal-title":"Lancet"},{"key":"ref_4","unstructured":"WHO (2023, May 08). Noncommunicable Diseases: Risk Factors. World Health Organization. 2021. p. 1. Available online: https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/topic-details\/GHO\/ncd-risk-factors."},{"key":"ref_5","unstructured":"World Obesity Federation (2023, July 27). World Obesity Atlas 2023. Available online: https:\/\/www.worldobesity.org\/resources\/resource-library\/world-obesity-atlas-2023."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/j.1467-789X.2008.00529.x","article-title":"Sex differences in obesity and the regulation of energy homeostasis","volume":"10","author":"Lovejoy","year":"2009","journal-title":"Obes. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1089\/lap.2014.0639","article-title":"Benefits of bariatric surgery do not reach obese men","volume":"25","author":"Fuchs","year":"2015","journal-title":"J. Laparoendosc. Adv. Surg. Tech. A"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kroll, D.S., Feldman, D.E., Biesecker, C.L., McPherson, K.L., Manza, P., Joseph, P.V., Volkow, N.D., and Wang, G.-J. (2020). Neuroimaging of Sex\/Gender Differences in Obesity: A Review of Structure, Function, and Neurotransmission. Nutrients, 12.","DOI":"10.3390\/nu12071942"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1111\/obr.12527","article-title":"Sex\/gender differences in neural correlates of food stimuli: A systematic review of functional neuroimaging studies","volume":"18","author":"Chao","year":"2017","journal-title":"Obes. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1148\/radiol.2019181012","article-title":"Obesity, Brain Volume, and White Matter Microstructure at MRI: A Cross-sectional UK Biobank Study","volume":"291","author":"Dekkers","year":"2019","journal-title":"Radiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/j.psyneuen.2011.04.005","article-title":"Comfort food is comforting to those most stressed: Evidence of the chronic stress response network in high stress women","volume":"36","author":"Tomiyama","year":"2011","journal-title":"Psychoneuroendocrinology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40337-018-0210-6","article-title":"Emotional eating and weight regulation: A qualitative study of compensatory behaviors and concerns","volume":"6","author":"Frayn","year":"2018","journal-title":"J. Eat. Disord."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0079-6123(06)53004-3","article-title":"Chapter 4: Glucocorticoids, chronic stress, and obesity","volume":"153","author":"Dallman","year":"2006","journal-title":"Prog. Brain Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1542\/peds.2012-1106","article-title":"Weight-Based Victimization: Bullying Experiences of Weight Loss Treatment\u2013Seeking Youth","volume":"131","author":"Puhl","year":"2013","journal-title":"Pediatrics"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.yfrne.2010.02.004","article-title":"Pubertal maturation and programming of hypothalamic-pituitary-adrenal reactivity","volume":"31","author":"Romeo","year":"2010","journal-title":"Front. Neuroendocr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1002\/cphy.c150015","article-title":"Regulation of the hypothalamic-pituitary-adrenocortical stress response","volume":"6","author":"Herman","year":"2016","journal-title":"Compr. Physiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"E927","DOI":"10.1152\/ajpendo.1991.260.6.E927","article-title":"Role of glucocorticoid in the regulation of glycogen metabolism in skeletal muscle","volume":"260","author":"Coderre","year":"1991","journal-title":"Am. J. Physiol.-Endocrinol. Metab."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1159\/000455865","article-title":"Hypothalamic Insulin Resistance in Obesity: Effects on Glucose Homeostasis","volume":"104","author":"Chen","year":"2017","journal-title":"Neuroendocrinology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1111\/jne.12179","article-title":"Stress and the Reproductive Axis","volume":"26","author":"Toufexis","year":"2014","journal-title":"J. Neuroendocr."},{"key":"ref_20","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_21","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1038\/nrendo.2017.64","article-title":"Type 2 diabetes mellitus and psychological stress\u2014A modifiable risk factor","volume":"13","author":"Hackett","year":"2017","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1136\/bmj.38693.435301.80","article-title":"Chronic stress at work and the metabolic syndrome: Prospective study","volume":"332","author":"Chandola","year":"2006","journal-title":"BMJ"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.physbeh.2013.08.010","article-title":"Chronic stress exposure may affect the brain\u2019s response to high calorie food cues and predispose to obesogenic eating habits","volume":"120","author":"Tryon","year":"2013","journal-title":"Physiol. Behav."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s40273-014-0243-x","article-title":"The Epidemiology of Obesity: A Big Picture","volume":"33","author":"Hruby","year":"2014","journal-title":"Pharmacoeconomics"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2271","DOI":"10.3389\/fpsyg.2018.02271","article-title":"Weight Bias Internalization Among Adolescents Seeking Weight Loss: Implications for Eating Behaviors and Parental Communication","volume":"9","author":"Puhl","year":"2018","journal-title":"Front. Psychol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1002\/eat.22459","article-title":"Does childhood bullying predict eating disorder symptoms? A prospective, longitudinal analysis","volume":"48","author":"Copeland","year":"2015","journal-title":"Int. J. Eat. Disord."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.yfrne.2013.10.004","article-title":"Puberty and adolescence as a time of vulnerability to stressors that alter neurobehavioral processes","volume":"35","author":"Holder","year":"2013","journal-title":"Front. Neuroendocr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1080\/10615800903377264","article-title":"The role of neuroticism and extraversion in the stress-anxiety and stress-depression relationships","volume":"23","author":"Uliaszek","year":"2010","journal-title":"Anxiety Stress. Coping"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/eat.20625","article-title":"Gender difference in the prevalence of eating disorder symptoms","volume":"42","author":"Rosselli","year":"2009","journal-title":"Int. J. Eat. Disord."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1002\/eat.23320","article-title":"Low testosterone is associated with dysregulated eating symptoms in young adult men","volume":"53","author":"Culbert","year":"2020","journal-title":"Int. J. Eat. Disord."},{"key":"ref_31","first-page":"70","article-title":"Addressing male obesity: An evaluation of a group-based weight management intervention for Scottish men","volume":"6","author":"Gray","year":"2009","journal-title":"J. Men\u2019s Health"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.socscimed.2005.05.032","article-title":"Barriers to healthy eating amongst men: A qualitative analysis","volume":"62","author":"Gough","year":"2006","journal-title":"Soc. Sci. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.mce.2014.11.029","article-title":"The sexual dimorphism of obesity","volume":"402","author":"Palmer","year":"2015","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1093\/ajcn\/55.5.950","article-title":"Sex- and menopause-associated changes in body-fat distribution","volume":"55","author":"Ley","year":"1992","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/cen.12505","article-title":"Android and gynoid fat percentages and serum lipid levels in United States adults","volume":"82","author":"Min","year":"2015","journal-title":"Clin. Endocrinol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Farkhondeh, T., Llorens, S., Pourbagher-Shahri, A.M., Ashrafizadeh, M., Talebi, M., Shakibaei, M., and Samarghandian, S. (2020). An Overview of the Role of Adipokines in Cardiometabolic Diseases. Molecules, 25.","DOI":"10.3390\/molecules25215218"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.metabol.2009.04.038","article-title":"The influence of sex, body composition, and nonesterified fatty acids on serum adipokine concentrations","volume":"58","author":"Plaisance","year":"2009","journal-title":"Metabolism"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1038\/sj.ijo.0801730","article-title":"Sexual dimorphism in circulating leptin concentrations is not accounted for by differences in adipose tissue distribution","volume":"25","author":"Rosenbaum","year":"2001","journal-title":"Int. J. Obes."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1111\/j.1559-4572.2008.00030.x","article-title":"The Role of Adiponectin in Obesity, Diabetes, and Cardiovascular Disease","volume":"4","author":"Kawano","year":"2009","journal-title":"J. CardioMetabolic Syndr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1007\/s00125-003-1074-z","article-title":"Relationship of adiponectin to body fat distribution, insulin sensitivity and plasma lipoproteins: Evidence for independent roles of age and sex","volume":"46","author":"Cnop","year":"2003","journal-title":"Diabetologia"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.chemphyslip.2018.12.005","article-title":"Association between serum resistin, adiposity measures and inflammatory makers in women without cardiovascular diseases","volume":"218","author":"Alissa","year":"2019","journal-title":"Chem. Phys. Lipids."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"E745","DOI":"10.1152\/ajpendo.2001.280.5.E745","article-title":"Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance","volume":"280","author":"Kern","year":"2001","journal-title":"Am. J. Physiol.-Endocrinol. Metab."},{"key":"ref_43","first-page":"196","article-title":"TNF-alpha, soluble TNF receptor and interleukin-6 plasma levels in the general population","volume":"17","author":"Himmerich","year":"2006","journal-title":"Eur. Cytokine Netw."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1172\/JCI92035","article-title":"Inflammatory mechanisms linking obesity and metabolic disease","volume":"127","author":"Saltiel","year":"2017","journal-title":"J. Clin. Investig."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"141","DOI":"10.4049\/jimmunol.2000490","article-title":"Sex Differences in Macrophage Responses to Obesity-Mediated Changes Determine Migratory and Inflammatory Traits","volume":"206","author":"Chen","year":"2020","journal-title":"J. Immunol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.cmet.2014.09.010","article-title":"Obesity and FTO: Changing Focus at a Complex Locus","volume":"20","author":"Tung","year":"2014","journal-title":"Cell Metab."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1038\/2407","article-title":"A frameshift mutation in human MC4R is associated with a dominant form of obesity","volume":"20","author":"Vaisse","year":"1998","journal-title":"Nat. Genet."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1038\/2404","article-title":"A frameshift mutation in MC4R associated with dominantly inherited human obesity","volume":"20","author":"Yeo","year":"1998","journal-title":"Nat. Genet."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.molmet.2017.06.015","article-title":"Evaluation of a melanocortin-4 receptor (MC4R) agonist (Setmelanotide) in MC4R deficiency","volume":"6","author":"Collet","year":"2017","journal-title":"Mol. Metab."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1093","DOI":"10.1172\/JCI0215693","article-title":"Beneficial effects of leptin on obesity, T cell hyporesponsiveness, and neuroendocrine\/metabolic dysfunction of human congenital leptin deficiency","volume":"110","author":"Farooqi","year":"2002","journal-title":"J. Clin. Investig."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"T63","DOI":"10.1530\/JOE-14-0480","article-title":"Human disorders of leptin action","volume":"223","author":"Farooqi","year":"2014","journal-title":"J. Endocrinol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1042\/BCJ20160616","article-title":"Cellular and disease functions of the prader-willi syndrome gene magel2","volume":"474","author":"Tacer","year":"2017","journal-title":"Biochem. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2548","DOI":"10.1210\/jc.2004-0395","article-title":"Adipose Tissue as an Endocrine Organ","volume":"89","author":"Kershaw","year":"2004","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1530\/EJE-16-0200","article-title":"Relationships between insulin resistance and frailty with body composition and testosterone in men undergoing androgen deprivation therapy for prostate cancer","volume":"175","author":"Cheung","year":"2016","journal-title":"Eur. J. Endocrinol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1007\/s11695-012-0734-9","article-title":"Hypogonadotropic Hypogonadism in Morbidly Obese Males Is Reversed After Bariatric Surgery","volume":"22","author":"Pellitero","year":"2012","journal-title":"Obes. Surg."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"R123","DOI":"10.1530\/REP-17-0161","article-title":"Obesity, a serious etiologic factor for male subfertility in modern society","volume":"154","author":"Liu","year":"2017","journal-title":"Reproduction"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/andr.12135","article-title":"Prevalence of male secondary hypogonadism in moderate to severe obesity and its relationship with insulin resistance and excess body weight","volume":"4","author":"Galindo","year":"2016","journal-title":"Andrology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1210\/jcem-48-4-633","article-title":"Increased Estrogen Production in Obese Men","volume":"48","author":"Schneider","year":"1979","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"488","DOI":"10.5483\/BMBRep.2016.49.9.141","article-title":"Extra-gonadal sites of estrogen biosynthesis and function","volume":"49","author":"Barakat","year":"2016","journal-title":"BMB Rep."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1530\/EJE-12-0955","article-title":"Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: A systematic review and meta-analysis","volume":"168","author":"Corona","year":"2013","journal-title":"Eur. J. Endocrinol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1530\/EJE-07-0663","article-title":"Letrozole once a week normalizes serum testosterone in obesity-related male hypogonadism","volume":"158","author":"Loves","year":"2008","journal-title":"Eur. J. Endocrinol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.2337\/dc11-0208","article-title":"Low Estradiol Concentrations in Men with Subnormal Testosterone Concentrations and Type 2 Diabetes","volume":"34","author":"Dhindsa","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.2337\/dc09-1649","article-title":"Testosterone Concentrations in Diabetic and Nondiabetic Obese Men","volume":"33","author":"Dhindsa","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"285","DOI":"10.2147\/DMSO.S7384","article-title":"The economic impact of obesity in the United States","volume":"3","author":"Hammond","year":"2010","journal-title":"Diabetes Metab. Syndr. Obesity Targets Ther."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1530\/EJE-17-0673","article-title":"Diminished androgen and estrogen receptors and aromatase levels in hypogonadal diabetic men: Reversal with testosterone","volume":"178","author":"Ghanim","year":"2018","journal-title":"Eur. J. Endocrinol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1530\/EJE-11-1051","article-title":"Comparison of serum testosterone and estradiol measurements in 3174 European men using platform immunoassay and mass spectrometry; relevance for the diagnostics in aging men","volume":"166","author":"Huhtaniemi","year":"2012","journal-title":"Eur. J. Endocrinol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1038\/nrn.2017.168","article-title":"Leptin and the maintenance of elevated body weight","volume":"19","author":"Pan","year":"2018","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0167-0115(00)00144-0","article-title":"Leptin effects on pulsatile gonadotropin releasing hormone secretion from the adult rat hypothalamus and interaction with cocaine and amphetamine regulated transcript peptide and neuropeptide Y","volume":"92","author":"Parent","year":"2000","journal-title":"Regul. Pept."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.tem.2010.08.002","article-title":"Obesity and leptin resistance: Distinguishing cause from effect","volume":"21","author":"Myers","year":"2010","journal-title":"Trends Endocrinol. Metab. TEM"},{"key":"ref_70","first-page":"3673","article-title":"Leptin and Androgens in Male Obesity: Evidence for Leptin Contribution to Reduced Androgen Levels*","volume":"84","author":"Isidori","year":"1999","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/j.1439-0272.2006.00754.x","article-title":"Expression of leptin and leptin receptor in the testis of fertile and infertile patients","volume":"39","author":"Ishikawa","year":"2007","journal-title":"Andrologia"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2510","DOI":"10.1210\/jcem.82.8.4174","article-title":"Testosterone Substitution Normalizes Elevated Serum Leptin Levels in Hypogonadal Men","volume":"82","author":"Blum","year":"1997","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1210\/js.2017-00062","article-title":"Effect of testosterone treatment onadipokines and gut hormones in obese men on a hypocaloric diet","volume":"1","author":"Fui","year":"2017","journal-title":"J. Endocr. Soc."},{"key":"ref_74","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":"ref_75","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1093\/humupd\/dms050","article-title":"BMI in relation to sperm count: An updated systematic review and collaborative meta-analysis","volume":"19","author":"Sermondade","year":"2012","journal-title":"Hum. Reprod. Updat."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1161\/CIR.0000000000000366","article-title":"Executive summary: Heart disease and stroke statistics-2016 update: A Report from the American Heart Association","volume":"133","author":"Mozaffarian","year":"2016","journal-title":"Circulation"},{"key":"ref_77","unstructured":"(2023, May 08). National Diabetes Statistics Report, 2020|CDC, Available online: https:\/\/www.cdc.gov\/diabetes\/data\/statistics-report\/index.html."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1001\/archinte.158.5.466","article-title":"Obesity, Health Services Use, and Health Care Costs Among Members of a Health Maintenance Organization","volume":"158","author":"Quesenberry","year":"1998","journal-title":"Arch. Intern. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.pop.2015.08.013","article-title":"Economic Impact of Obesity","volume":"43","author":"Spieker","year":"2016","journal-title":"Prim. Care Clin. Off. Pract."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"536","DOI":"10.2165\/00019053-199406060-00007","article-title":"Costs of Illness in Cost-Effectiveness Analysis: A Review of the Methodology","volume":"6","author":"Hodgson","year":"1994","journal-title":"Pharmacoeconomics"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1111\/j.1467-789X.2008.00472.x","article-title":"Indirect costs of obesity: A review of the current literature","volume":"9","author":"Trogdon","year":"2008","journal-title":"Obes. Rev."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.2337\/dc10-2415","article-title":"Benefits of Modest Weight Loss in Improving Cardiovascular Risk Factors in Overweight and Obese Individuals with Type 2 Diabetes","volume":"34","author":"Wing","year":"2011","journal-title":"Diabetes Care"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"The Look Ahead Research (2014). Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study. Obesity, 22, 5\u201313.","DOI":"10.1002\/oby.20662"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1056\/NEJMoa021423","article-title":"Overweight, Obesity, and Mortality from Cancer in a Prospectively Studied Cohort of U.S. Adults","volume":"348","author":"Calle","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.coph.2016.07.005","article-title":"Obesity and cancer: Inflammation bridges the two","volume":"29","author":"Kolb","year":"2016","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.critrevonc.2013.01.005","article-title":"The key role of growth hormone-insulin-IGF-1 signaling in aging and cancer","volume":"87","author":"Anisimov","year":"2013","journal-title":"Crit. Rev. Oncol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1158\/1078-0432.CCR-12-0930","article-title":"Molecular Pathways: Adiponectin and Leptin Signaling in Cancer","volume":"19","author":"VanSaun","year":"2013","journal-title":"Clin. Cancer Res."},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Guti\u00e9rrez-Cuevas, J., Santos, A., and Armendariz-Borunda, J. (2021). Pathophysiological Molecular Mechanisms of Obesity: A Link between MAFLD and NASH with Cardiovascular Diseases. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms222111629"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/jgh.15713","article-title":"Diet and gut microbiome in fatty liver and its associated liver cancer","volume":"37","author":"Pan","year":"2021","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/hepr.13898","article-title":"Effects of sodium glucose cotransporter 2 inhibitors and pioglitazone on FIB-4 index in metabolic-associated fatty liver disease","volume":"53","author":"Mino","year":"2023","journal-title":"Hepatol. Res."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"109791","DOI":"10.1016\/j.diabres.2022.109791","article-title":"Dapagliflozin for nonalcoholic fatty liver disease: A systematic review and meta-analysis","volume":"185","author":"He","year":"2022","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1002\/oby.21653","article-title":"How Strongly Does Appetite Counter Weight Loss? Quantification of the Feedback Control of Human Energy Intake","volume":"24","author":"Polidorir","year":"2016","journal-title":"Obesity"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"101237","DOI":"10.1016\/j.molmet.2021.101237","article-title":"Challenges in tackling energy expenditure as obesity therapy: From preclinical models to clinical application","volume":"51","author":"Betz","year":"2021","journal-title":"Mol. Metab."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"E875","DOI":"10.1503\/cmaj.191707","article-title":"Obesity in adults: A clinical practice guideline","volume":"192","author":"Wharton","year":"2020","journal-title":"Can. Med Assoc. J."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1124\/pr.117.014803","article-title":"Anti-Obesity Therapy: From Rainbow Pills to Polyagonists","volume":"70","author":"Clemmensen","year":"2018","journal-title":"Pharmacol. Rev."},{"key":"ref_96","first-page":"817","article-title":"Obesity management: Update on orlistat","volume":"3","author":"Drew","year":"2007","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1007\/s40265-015-0427-5","article-title":"Naltrexone ER\/Bupropion ER: A Review in Obesity Management","volume":"75","author":"Greig","year":"2015","journal-title":"Drugs"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"4473","DOI":"10.1172\/JCI75276","article-title":"The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss","volume":"124","author":"Secher","year":"2014","journal-title":"J. Clin. Investig."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1056\/NEJMoa1603827","article-title":"Liraglutide and cardiovascular outcomes in type 2 diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1056\/NEJMoa1607141","article-title":"Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes","volume":"375","author":"Marso","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_101","first-page":"205","article-title":"Tirzepatide Once Weekly for the Treatment of Obesity","volume":"387","author":"Frias","year":"2023","journal-title":"Lancet"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2048","DOI":"10.1111\/dom.13764","article-title":"Efficacy and safety of an expanded dulaglutide dose range: A phase 2, placebo-controlled trial in patients with type 2 diabetes using metformin","volume":"21","author":"Frias","year":"2019","journal-title":"Diabetes Obes. Metab."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/S2213-8587(22)00188-7","article-title":"Efficacy and safety of tirzepatide monotherapy compared with dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono): A double-blind, multicentre, randomised, phase 3 trial","volume":"10","author":"Inagaki","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_104","first-page":"306","article-title":"Triple-Hormone Combination Retatrutide Induces 24% Body Weight Loss","volume":"330","author":"Harris","year":"2023","journal-title":"JAMA"},{"key":"ref_105","doi-asserted-by":"crossref","unstructured":"Jastreboff, A.M., Kaplan, L.M., Fr\u00edas, J.P., Wu, Q., Du, Y., Gurbuz, S., Coskun, T., Haupt, A., Milicevic, Z., and Hartman, M.L. (N. Engl. J. Med., 2023). Triple-Hormone-Receptor Agonist Retatrutide for Obesity\u2014A Phase 2 Trial, N. Engl. J. Med., online ahead of print.","DOI":"10.1056\/NEJMoa2301972"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.metabol.2018.10.010","article-title":"Pharmacotherapy of obesity: Available medications and drugs under investigation","volume":"92","author":"Pilitsi","year":"2019","journal-title":"Metabolism"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1161\/CIRCRESAHA.116.307591","article-title":"Treatment of obesity","volume":"118","author":"Wolfe","year":"2016","journal-title":"Circ. Res."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"e54","DOI":"10.2105\/AJPH.2015.302773","article-title":"Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records","volume":"105","author":"Fildes","year":"2015","journal-title":"Am. J. Public Health"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1007\/s00464-017-5819-z","article-title":"Physiologic and psychological gender differences in bariatric surgery","volume":"32","author":"Kochkodan","year":"2017","journal-title":"Surg. Endosc."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.jamcollsurg.2015.11.033","article-title":"A Decade Analysis of Trends and Outcomes of Male vs Female Patients Who Underwent Bariatric Surgery","volume":"222","author":"Young","year":"2016","journal-title":"J. Am. Coll. Surg."},{"key":"ref_111","first-page":"3","article-title":"Long-Term Outcomes After Bariatric Surgery: A Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding","volume":"29","author":"Hindle","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1159\/000481825","article-title":"Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management","volume":"10","author":"Busetto","year":"2017","journal-title":"Obes. Facts"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1007\/s11695-007-9117-z","article-title":"Changes in Resting Energy Expenditure and Body Composition after Weight Loss following Roux-en-Y Gastric Bypass","volume":"17","author":"Carrasco","year":"2007","journal-title":"Obes. Surg."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"2450","DOI":"10.1007\/s11695-020-04397-4","article-title":"Evaluation of Heart Rate Variability and Endothelial Function 3 Months After Bariatric Surgery","volume":"30","author":"Braga","year":"2020","journal-title":"Obes Surg."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.jviscsurg.2013.08.005","article-title":"Evolution of low-grade systemic inflammation, insulin resistance, anthropometrics, resting energy expenditure and metabolic syndrome after bariatric surgery: A comparative study between gastric bypass and sleeve gastrectomy","volume":"150","author":"Iannelli","year":"2013","journal-title":"J. Visc. Surg."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1038\/oby.2007.554","article-title":"Impact of surgically induced weight loss on cardiovascular autonomie function: One-year follow-up","volume":"15","author":"Maser","year":"2007","journal-title":"Obesity"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.soard.2014.09.011","article-title":"Improvement of heart rate variability after decreased insulin resistance after sleeve gastrectomy for morbidly obesity patients","volume":"11","author":"Wu","year":"2014","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.atherosclerosis.2014.02.034","article-title":"Bariatric surgery in morbidly obese patients improves the atherogenic qualitative properties of the plasma lipoproteins","volume":"234","author":"Julve","year":"2014","journal-title":"Atherosclerosis"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"1702","DOI":"10.1378\/chest.106.6.1702","article-title":"Recurrence of Sleep Apnea Without Concomitant Weight Increase 7.5 Years After Weight Reduction Surgery","volume":"106","author":"Pillar","year":"1994","journal-title":"Chest"},{"key":"ref_120","doi-asserted-by":"crossref","unstructured":"Tremmel, M., Gerdtham, U.-G., Nilsson, P.M., and Saha, S. (2017). Economic Burden of Obesity: A Systematic Literature Review. Int. J. Environ. Res. Public Health, 14, Available online: https:\/\/www.mdpi.com\/1660-4601\/14\/4\/435\/htm.","DOI":"10.3390\/ijerph14040435"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"w822","DOI":"10.1377\/hlthaff.28.5.w822","article-title":"Annual Medical Spending Attributable to Obesity: Payer-And Service-Specific Estimates","volume":"28","author":"Finkelstein","year":"2009","journal-title":"Health Aff."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.jhealeco.2011.10.003","article-title":"The medical care costs of obesity: An instrumental variables approach","volume":"31","author":"Cawley","year":"2012","journal-title":"J. Health Econ."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5354\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:36:02Z","timestamp":1760128562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,17]]},"references-count":122,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jcm12165354"],"URL":"https:\/\/doi.org\/10.3390\/jcm12165354","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,17]]}}}