Molecular tissue perturbations and trajectories in people with obesity undergoing weight cycling during medical- and surgical versus lifestyle interventions - an observational clinical trial

Game changing improvements in obesity treatment have been achieved in recent years with both bariatric surgery and GLP1-based medicines.

However, all current obesity treatments are associated with risk of obesity regain and weight cycling, which may have detrimental effects, overruling the otherwise proven health benefits of weight loss.Animal studies have shown that the subcutaneous adipose tissue (SAT) retains its obesity-associated immunological, morphological, and metabolic perturbations after weight loss, indicating SAT imprinting by epigenetic mechanisms.

While such changes may contribute to weight cycling, there is a paucity of human studies of the mechanisms underlying weight cycling following lifestyle, medical and surgical interventions.We aim to establish a large-scale prospective observational study to evaluate the treatment responses, weight trajectories, SAT molecular characteristics, as well as the changes in the SAT plasticity during the weight loss and weight cycling, in obese patients referred to the Obesity Clinic at the Skåne University Hospital in Malmö, for medical and surgical compared with lifestyle intervention.

We here apply for funding for a pilot/feasibility study, SAT biopsies assay optimization and quality tests, statistical power analysis optimization, biobank and database establishment, local and national stakeholder management including patient involvement and collaborations with other regions, as well as preparation of funding applications.