Ozojide Kingsley O, Adjei Esther M, Aderinola Oluwafolakemi M, Okobi Okelue E, Nguma Chiazor B
Public Health, Nottingham Trent University, Nottingham, GBR.
Internal Medicine, The Trust Hospital Company Limited, Accra, GHA.
Cureus. 2025 Jul 23;17(7):e88571. doi: 10.7759/cureus.88571. eCollection 2025 Jul.
Long-term weight loss maintenance remains a significant challenge in obesity management, despite advances in behavioral, dietary, and medical interventions. The objective of this study is to identify consistent genetic and behavioral predictors associated with sustained weight loss in adults with overweight or obesity.
We searched PubMed, Embase, PsycINFO, Web of Science, and Google Scholar for peer-reviewed studies published from January 2010 to April 2025. Eligible studies included observational and genetic investigations involving adults who maintained at least 10% weight loss for one year or more. Quality was assessed using the Newcastle-Ottawa Scale (NOS) and genetic validity criteria. A thematic synthesis categorized predictors as behavioral or genetic.
24 studies met the inclusion criteria (15 observational, nine genetic). Consistent behavioral predictors included increased physical activity, dietary restraint, low disinhibition, and improved psychological health. Genetically, FTO risk alleles and higher polygenic risk scores were associated with weight regain; however, structured behavioral interventions mitigated this effect. Specific gene variants (e.g., PPARγ, TIMP4) were linked to enhanced weight loss outcomes in response to multidisciplinary interventions.
Both genetic and behavioral factors independently and interactively influence long-term weight loss maintenance. Integrating genetic risk profiling with personalized behavioral strategies may improve obesity treatment outcomes.
尽管在行为、饮食和医学干预方面取得了进展，但长期维持体重减轻仍然是肥胖管理中的一项重大挑战。本研究的目的是确定与超重或肥胖成年人持续体重减轻相关的一致的遗传和行为预测因素。
我们在PubMed、Embase、PsycINFO、Web of Science和谷歌学术搜索了2010年1月至2025年4月发表的同行评审研究。符合条件的研究包括涉及体重减轻至少10%并维持一年或更长时间的成年人的观察性和基因研究。使用纽卡斯尔-渥太华量表（NOS）和基因有效性标准评估质量。主题综合将预测因素分为行为或遗传因素。
有24项研究符合纳入标准（15项观察性研究，9项基因研究）。一致的行为预测因素包括增加身体活动、饮食节制、低去抑制性和改善心理健康。在基因方面，FTO风险等位基因和较高的多基因风险评分与体重反弹相关；然而，结构化行为干预减轻了这种影响。特定基因变异（如PPARγ、TIMP4）与多学科干预后体重减轻效果增强有关。
遗传和行为因素独立且相互作用地影响长期体重减轻维持。将遗传风险分析与个性化行为策略相结合可能会改善肥胖治疗效果。
