Patients with Obesity: Baseline Body Composition, Follow-Up Retention, and Longitudinal Changes-A Single-Center...

Area of Science:

• Endocrinology
• Metabolic Health
• Obesity Medicine

Background:

• Increasing obesity severity is linked to adverse metabolic profiles.
• Body composition changes significantly with rising body mass index (BMI).
• Diabetes mellitus (DM) prevalence increases with obesity severity.

Purpose of the Study:

• Define body composition phenotypes associated with obesity severity.
• Quantify follow-up retention and weight loss in an obesity clinic.
• Explore the relationship between DM and body composition beyond BMI.

Main Methods:

• Cross-sectional analysis of 2879 adults (including non-obese subgroup) from an obesity clinic database.
• Longitudinal analysis of 730 patients with obesity and repeat bioelectrical impedance analysis (BIA) at 6+ months.
• Classification of patients based on BMI and glycemic status.

Main Results:

• Higher BMI correlated with elevated glucose, HbA1c, triglycerides, and inflammatory markers; lower HDL cholesterol.
• Body composition deterioration driven by visceral fat and fat-to-muscle ratio, not muscle mass.
• Diabetes prevalence increased with BMI; most pronounced DM-related body composition differences in BMI 30-39.9 kg/m² group.

Conclusions:

• Increasing obesity severity is associated with poorer metabolic profiles and greater adiposity.
• Diabetes-related body composition differences vary by BMI category, most notable in moderate obesity (BMI 30-39.9 kg/m²).
• Low follow-up rates and limited weight loss underscore the need for refined obesity phenotyping incorporating body composition.