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Obesity is a chronic, recurring, progressive disease and a major public health problem associated with several other diseases that lead to disability, morbidity, and mortality. The prevalence of obesity has increased at pandemic levels, along with increasing weight-related comorbidities and deaths worldwide. Lifestyle interventions alone provide clinically significant long-term weight loss in only a small proportion of individuals, and bariatric surgery is not suitable or desirable for all patients. Historically, anti-obesity medications achieved a mean efficacy with weight loss between 5 and 10%, which significantly impacted several comorbidities and risk factors, but the average efficacy of these medications remained lower than that expected by both patients and health care professionals and eventually curbed long-term use. Moreover, there is no direct evidence on the impact of anti-obesity medications on cardiovascular outcomes. Semaglutide is a newer anti-obesity medication that changes the overall landscape, as phase 3 studies show a mean weight loss near the 15% threshold and significant proportions of patients with a weight loss of greater than 20%. In this review, we focus on the currently available anti-obesity medications, discuss the results of semaglutide, and present perspectives on the future of obesity treatment after semaglutide.

Background Obesity is a chronic and complex disease influenced by various factors that hinder weight loss and maintenance. However, perceptions of obesity are often marked by stigma. This study assessed perceptions of obesity, weight stigma, health habits, and emotional eating in a representative sample of the Brazilian population. Methods This cross-sectional study included a representative sample of 2560 Brazilian participants. Data were collected from structured online questionnaires covering demographic aspects, perceptions of obesity, stigma, health habits, and behaviors related to emotional eating. Results The prevalence of obesity in the sample was 26%. However, 61% of these individuals did not receive a formal diagnosis. Although 76% of the participants considered obesity a disease, 65% believed that diet and exercise were sufficient treatments. Only 5% of the participants with obesity considered 10% weight loss beneficial for associated comorbidities. It was widely believed that normalizing body mass index (BMI) is necessary for positive health outcomes. Emotional eating behaviors were slightly more prevalent among individuals with obesity (25%) but were present across all BMI ranges. Conclusions The findings of this investigation underscore the necessity for comprehensive education regarding obesity as a complex multifactorial condition. They emphasize the importance of promoting awareness of the benefits associated with modest weight reduction, improving the diagnosis and documentation of obesity in clinical settings, and implementing targeted interventions to address misconceptions concerning treatment modalities and the impact of emotional eating behaviors.

The COVID-19 pandemic led to an unprecedented crisis, and early on, it has been shown that diabetes is an important risk factor for complications and mortality in infected patients, as demonstrated by several studies. Moreover, hyperglycemia, regardless of whether patients have diabetes, is associated with poorer outcomes, which suggests that adequate monitoring and treatment of elevated glycemia in the hospital setting can improve patient outcomes. In patients with COVID-19, glycemic control may be impaired as a consequence of the infection itself (aggravating pre-existing diabetes and potentially precipitating new-onset diabetes), inflammation, or corticosteroid use—a well-established therapy to reduce COVID-19 complications, especially in the intensive care unit. This article reviews the link between diabetes and hyperglycemia, and COVID-19, with a brief review of potential mechanisms, along with emerging evidence on the effect of glycemic control on COVID-19 outcomes, especially in hospital settings.

[...]this study will explore the concept of media literacy and its most incisive variant, critical media literacy (CML), and its importance and impact on higher education institutions and students. [...]the significance of this study is that CML may encourage faculty in higher education institutions to promote classes, programs, and workshops to students, including those from majors unrelated to communication or journalism since it directly impacts people's ability to participate within their communities and broader society democratically. The Problem The rise of digital technologies and social media platforms has significantly changed the media landscape, leading to increased accessibility and democratization of information but also introducing new challenges and risks, such as misinformation, disinformation, fake news, and the emergence of a post-truth era (Buckingham, 2019). [...]media literacy is particularly important in a period of unbridled access to all sorts of content (Hobbs et al., 2022). Having inadequate media literacy skills means being at the mercy of the tides of mis- and disinformation. Since misinformation refers to false or inaccurate information regardless of whether there is intent to mislead (Allcott & Gentzkow, 2017; United Nations High Commissioner for Refugees [UNHCR], 2022), it will not be mentioned further.

To explore the impact of obesity on clinical outcomes, health-related quality of life, emotional well-being, and work productivity in people/patients with obesity across six countries by body mass index and the presence of complications. Adelphi Real World Obesity Disease Specific Programme™ captured data related to physicians and their consulting people/patients with obesity on a weight management program or anti-obesity medication in Brazil, Canada, China, Japan, Kingdom of Saudi Arabia, and the United Arab Emirates from April to December 2022. Physicians reported data for up to eight qualifying people/patients with obesity. People/patients with obesity voluntarily completed outcome measures: 36-Item Short Form Health Survey, emotional well-being, and Work Productivity and Activity Impairment. Of 1506 people/patients with obesity, 58% were female (mean ± standard deviation age: 41 ± 12.7 years; body mass index: 32.3 kg/m  ± 7.7 kg/m ). Overall, 82% had ⩾1 complication (median and interquartile range: 2.0 (1.0-3.0)). People/patients with obesity struggled with weight for a mean ± SD of 64.1 ± 86.6 months with a median (interquartile range) of 3.0 (2.0-5.0) weight-loss attempts. Mean ± standard deviation 36-Item Short Form Health Survey scores for people/patients with obesity above the obesity threshold showed impairment in general health (42.3 ± 11.5), social functioning (44.3 ± 9.2), role-emotional (46.0 ± 9.3), and mental health (45.7 ± 9.6). People/patients with obesity with complications showed similar impairment. People/patients with obesity reported bother/embarrassment about their weight, with 72% worried about future weight gain. Work productivity and activity impairment scores among people/patients with obesity above the obesity threshold showed impairment in activity (36%), overall work (34%), and presenteeism (31%). Findings were similar for people/patients with obesity with complications. Results suggest that obesity alongside the presence of complications negatively impacts health-related quality of life, emotional well-being, and work productivity, reinforcing the need for comprehensive interventions for this complex health issue.

Objective Melatonin has been shown to increase brown adipose tissue (BAT) mass, which can lead to important metabolic effects, such as bodyweight reduction and glycemic improvement. However, BAT mass can only be measured invasively and. The gold standard for non-invasive measurement of BAT activity is positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro- d -glucose ( 18 F-FDG PET). There is no study, to our knowledge, that has evaluated if melatonin influences BAT activity, measured by this imaging technique in animals. Methods Three experimental groups of Wistar rats (control, pinealectomy, and pinealectomy replaced with melatonin) had an 18 F-FDG PET performed at room temperature and after acute cold exposure. The ratio of increased BAT activity after cold exposure/room temperature was called “acute thermogenic capacity” (ATC) We also measured UCP-1 mRNA expression to correlate with the 18 F-FDG PET results. Results Pinealectomy led to reduced acute thermogenic capacity, compared with the other groups, as well as reduced UCP1 mRNA expression. Conclusion Melatonin deficiency impairs BAT response when exposed to acute cold exposure. These results can lead to future studies of the influence of melatonin on BAT, in animals and humans, without needing an invasive evaluation of BAT.

The effects of tirzepatide, a glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, on weight reduction after successful intensive lifestyle intervention are unknown. This double-blind, placebo-controlled trial randomized (1:1) adults with body mass index ≥30 or ≥27 kg/m 2 and at least one obesity-related complication (excluding diabetes), who achieved ≥5.0% weight reduction after a 12-week intensive lifestyle intervention, to tirzepatide maximum tolerated dose (10 or 15 mg) or placebo once weekly for 72 weeks ( n  = 579). The treatment regimen estimand assessed effects regardless of treatment adherence in the intention-to-treat population. The coprimary endpoint of additional mean per cent weight change from randomization to week 72 was met with changes of −18.4% (standard error (s.e.) 0.7) with tirzepatide and 2.5% (s.e. 1.0) with placebo (estimated treatment difference −20.8 percentage points (95% confidence interval (CI) −23.2%, −18.5%; P  < 0.001). The coprimary endpoint of the percentage of participants achieving additional weight reduction ≥5% was met with 87.5% (s.e. 2.2) with tirzepatide and 16.5% (s.e. 3.0) with placebo achieving this threshold (odds ratio 34.6%; 95% CI 19.2%, 62.6%; P  < 0.001). The most common adverse events with tirzepatide were gastrointestinal, with most being mild to moderate in severity. Tirzepatide provided substantial additional reduction in body weight in participants who had achieved ≥5.0% weight reduction with intensive lifestyle intervention. ClinicalTrials.gov registration: NCT04657016 . In the SURMOUNT-3 trial, once-weekly treatment with tirzepatide was demonstrated to result in clinically meaningful additional weight loss in adults with overweight or obesity following initial successful weight loss of at least 5% body weight with intensive lifestyle intervention.

The COVID-19 pandemic struck the world in 2020 and was particularly harsh in Latin America, where a combination of social disparities and vulnerabilities led to unprecedented health and economic crises.1 One remarkable impact is the exceedingly high death toll in the region, especially given the \"excess mortality rate,\" which is probably the measure that best reflects the total numbers of direct and indirect deaths during the COVID-19 pandemic.2,3When the pandemic hit Latin America, there was a misconception that its effect in the region would be lighter than that in Europe, considering the younger Latin American population. However, after accounting for the population age difference, the infection fatality rates were worse in Latin America and in low- and middle-income countries compared with higher-income European nations.2,4 Although age is an objective measure, different life course stressors could mean that individuals (and populations) with the same biological age will have extremely different health risks.5,6 Vulnerable individuals in low- and middleincome countries are commonly exposed to hazardous nutritional, environmental, and occupational factors and suffer from social marginalization, structural racism, and poverty. Therefore, comparing countries with large inequities with those with much less inequity based solely on age addresses the life course history and risks of populations facing COVID-19 only superficially. The implementation of social protection systems is a way to tackle vulnerabilities in the region. A governmental commitment to fiscally support such efforts and actively work with vulnerable populations to solve constraints and disparities is critical for Latin American states to adequately respond to future health crises.

A 3-year study of tirzepatide in participants with obesity and prediabetes showed substantial and sustained weight reduction and decreased risk of progression to diabetes with tirzepatide, as compared with placebo.

Intercultural competence reflects higher education institutions’ commitment to the internationalization of campus, programs, and curricula and results in attracting/retaining international students. Numerous studies explore international students’ challenges adapting to the receiving country; however, limited research investigates their experiences with intercultural competence. Thus, a phenomenological study was conducted to investigate the lived experiences of 12 international students with intercultural competence at a Southwest Florida university. The constant comparison method identified three dimensions of the participants’ lived experiences: institutional, curricular, and interpersonal. The findings indicated a lack of intercultural competence in each dimension, significantly impacting students’ academic and social experiences.