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The Global Obesity Landscape: Not a Uniform EpidemicA continuing rise in obesity around the world is not inevitable, research suggests, with rates in some countries levelling off or potentially in decline. Researchers say focusing on what has been described as a global epidemic of obesity hides large variations in trends across different countries, sexes and age groups.Majid Ezzati, a professor of global environmental health at Imperial College London and author of the study, said: "I think the thing that's really important is this diversity exists even across countries that have really similar economic, environmental, technological features. So countries may look the same on the surface of it but obesity looks different."Comprehensive Analysis Reveals Complex PatternsWriting in the journal Nature, the international team, which involved a network of almost 2,000 researchers, described how for each country they calculated the change in the prevalence of obesity each year between 1980 and 2024. They drew on data from 4,050 population-based studies involving 232 million participants aged five years and above.They found that the prevalence of obesity increased in almost all countries over the 45-year period. However, in most high-income countries, a rapid rise in the prevalence of obesity has been replaced by a slower increase, a plateau, or a potential decline.Regional Variations in Obesity PrevalenceThe rate of growth in obesity is slowing in adults in the US and UK, reaching a prevalence of 40-43% and 27-30% respectively in 2024. Obesity is increasing steadily in Finland, has plateaued in Germany and may have started to decline in France, where 24-25%, 20-23% and 11-12% of adults respectively were thought to have the condition in 2024.Slowdowns were often seen in children and adolescents before adults. For the former group, the slowdown started as early as 1990 in Denmark and rates stabilised in most high-income countries by the mid-2000s. Obesity has plateaued in boys and girls in the UK, US, Germany and Japan at prevalences of 10-12%, 20-23%, 7-12% and 3-7% respectively.Meanwhile, obesity among young people and adults in many low-income and middle-income countries continues to rise and in some cases this is accelerating.Understanding the Drivers Behind Divergent TrendsThe team say it is important now to unpick what is behind the trends in different countries. The situation is complex: while there may be shared reasons for obesity, such easy access to unhealthy foods or a decrease in physical activity, the team say country-specific factors rooted in social, economic and policy considerations could also be important, from perceptions around body image to the presence or absence of interventions such as healthy school meals.Naveed Sattar, a professor of metabolic medicine at the University of Glasgow, who was not involved in the work, said the study highlighted how obesity trends were diverging sharply across countries. "English-speaking nations are doing particularly poorly, with the UK now among the countries with the highest obesity levels worldwide," he said.Sattar said it was encouraging that some countries appeared to have reached a plateau in obesity rates. "Understanding what has worked in those settings is crucial as it could help shape more effective public health strategies for the UK," he said, although he noted there could be country-specific aspects or customs at play.Future Outlook and Potential InterventionsHe said the rapid rise in obesity across many developing countries was especially concerning, not least as it could result in increases in diabetes and cardiovascular conditions.He added: "Looking ahead, it will be important to see how wider use of effective weight-loss medicines affects obesity trends, particularly in the UK and the United States. Recent signs of stabilisation in the USA suggest there may be room for cautious optimism. Combining evidence-based medicines with strong public health measures could begin to shift obesity rates in the right direction."

The New Tool for Obesity-Related Disease Risk A new tool developed by UK researchers can help identify individuals most at risk of obesity-related diseases, such as type 2 diabetes, gout, and stroke. This tool uses a type of AI called interpretable machine learning to analyze data from nearly 200,000 participants of the UK Biobank project. How the Tool Works The researchers applied the AI tool to data from participants with a BMI of 27 or greater, identifying 20 health, lifestyle, and demographic features that could predict the 10-year risk of 18 different obesity-related complications. These features include age, sex, total cholesterol, and creatinine levels. The Data Analysis The team tested the validity of the tool, dubbed Obscore, using UK Biobank data and datasets from two independent health studies. The results showed that participants with the same age, sex, and BMI can have very different risks for various obesity-related conditions. The Impact Analysis The tool could help inform strategies for prioritizing who should receive weight-loss interventions, particularly in cases where access to NHS treatments is limited. According to Prof Nick Wareham, the tool is not about extending the use of particular therapies, but rather about developing and validating a score that can help with more rational resource allocation. The Prediction The researchers believe that their tool could be useful for prioritizing individuals who would benefit most from weight-loss medications. However, Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow, noted that substantial further development and validation will be required before such an approach can be translated into routine clinical practice.

Researchers have made a significant breakthrough in understanding why weight-loss medications, such as GLP1 receptor agonists, work better for some individuals than others. A recent study published in Nature has identified genetic variations in two genes involved in gut hormone pathways that regulate appetite and digestion. These genetic variations may help account for different weight-loss results or side-effects when taking glucagon-like peptide 1 (GLP1) medicines, which mimic natural gut hormones to regulate appetite, insulin release, and digestion. The study analyzed data from 27,885 patients on GLP1 drugs and found that specific genetic variants were associated with slightly more weight loss or side-effects like nausea and vomiting. The findings suggest that genetic differences may contribute to why people respond differently to weight-loss jabs. However, the overall impact of genetics appeared to be modest, with non-genetic factors such as sex, drug type, dose, and duration appearing to explain a substantially larger proportion of variability. The study's results reinforce that while there is substantial variability in response to GLP1 therapies, genetics is only one part of a much more complex picture. According to Marie Spreckley, an obesity expert at the University of Cambridge, the study provides plausible evidence that genetic variants could affect outcomes. However, she notes that the magnitude of these genetic effects is small in clinical terms, and that behavioral, clinical, and treatment-related factors remain the dominant drivers of outcomes. The study's authors suggest that their findings could support future efforts to use genetic information when making treatment choices for obesity. However, Spreckley cautions that the evidence is not yet sufficient to support using genetic information to guide treatment decisions in routine clinical practice.

The peptide-testing industry has seen a significant surge in demand, with laboratories testing thousands of unregulated substances claiming to support weight-loss and wellness. This growth is largely driven by the injectable peptide craze, with experts warning about the lack of reliable safety data and quality control.Peptides are short chains of amino acids, which can be found naturally in the body or made synthetically in laboratories. They include active ingredients in prescription weight-loss drugs, such as Wegovy, as well as experimental compounds pushed online by the booming biohacking and anti-ageing industries.Laboratories, such as Finnrick in Texas, have reported a substantial increase in testing requests, with around 60,000 samples processed annually, including roughly 2,000 orders from the UK since 2024. About a third of the products analysed failed basic quality checks, with issues including incorrect identity, purity, and quantity.Experts, including Dr. Luke Turnock and Peter Magic, have highlighted the risks associated with these unregulated substances, including potential long-term harms such as increased cancer risk and damage to organs. The large profit margins have also drawn nefarious actors into the supply chain.The UK is a significant market for peptides, with 2,000 testing orders since 2024, tied with Canada for third place globally. The Royal Pharmaceutical Society's Prof Amira Guirguis emphasized the need for oversight, traceability, and quality assurance in the peptide market.

Eli Lilly, the US pharmaceutical group behind the Mounjaro weight-loss drug, is seeking to resume its investments in the UK after pausing them last year. The company is in talks with UK ministers to regularly increase NHS drug prices and end a rebate scheme. Patrik Jonsson, president of Eli Lilly's international business, expressed optimism about reaching an agreement this summer.The talks will also explore 'innovative' pricing plans, such as linking payments for anti-obesity drugs to whether the treatment helps patients return to work. This comes as the US pharmaceutical industry increases pressure on the UK, with Keir Starmer agreeing to the first increase in NHS cost-effectiveness thresholds in 27 years. The threshold was raised from £20,000 to £30,000 a year for every year of life gained to £25,000 to £35,000.Eli Lilly was one of several pharmaceutical companies that ditched or paused almost £25bn in planned investments in the UK last year. The company paused its plans to invest in a laboratory site in central London. Jonsson stated that the resumption of Eli Lilly's investment would depend on the outcome of its talks with the government.He emphasized that prices for medicines in the UK had been 'far too low for far too long' and that the threshold couldn't remain static for another three decades. The UK agreed to pay 25% more for new medicines by 2035 as part of a US-UK drug pricing deal, which could eventually reach £9bn a year.Large pharmaceutical companies have protested about a 'rebate' scheme, under which they are required to pay back a chunk of revenue from sales of branded medicines. This scheme is expected to fall in 2026, although Jonsson believes payments 'should actually get down to zero' over time.