Obesity: pathophysiology and therapeutic interventions
Open accessAbstract
Over the past few decades, obesity has transitioned from a localized health concern to a pressing global public health crisis affecting over 650 million adults globally, as documented by WHO epidemiological surveys. As a chronic metabolic disorder characterized by pathological adipose tissue expansion, chronic inflammation, and neuroendocrine dysregulation that disrupts systemic homeostasis and impairs physiological functions, obesity is rarely an isolated condition; rather, it is frequently complicated by severe comorbidities that collectively elevate mortality risks. Despite advances in nutritional science and public health initiatives, sustained weight management success rates and prevention in obesity remain limited, underscoring its recognition as a multifactorial disease influenced by genetic, environmental, and behavioral determinants. Notably, the escalating prevalence of obesity and its earlier onset in younger populations have intensified the urgency to develop novel therapeutic agents that simultaneously ensure efficacy and safety. This review aims to elucidate the pathophysiological mechanisms underlying obesity, analyze its major complications—including type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), non-alcoholic fatty liver disease (NAFLD), obesity-related respiratory disorders, obesity-related nephropathy (ORN), musculoskeletal impairments, malignancies, and psychological comorbidities—and critically evaluate current anti-obesity strategies. Particular emphasis is placed on emerging pharmacological interventions, exemplified by plant-derived natural compounds such as berberine (BBR), with a focus on their molecular mechanisms, clinical efficacy, and therapeutic advantages. By integrating mechanistic insights with clinical evidence, this review seeks to provide innovative perspectives for developing safe, accessible, and effective obesity treatments.
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Obesity substantially increases the risk of diabetes, cardiovascular disease, fatty liver disease, and certain cancers.
“Obesity substantially increases the risk of diabetes, cardiovascular disease, fatty liver disease, and certain cancers, while imposing enormous societal and economic burdens.[2][3][4]”
From The Triple‐Agonist Revolution: Retatrutide and the Paradigm Shift in Multi‐Hormonal Pharmacotherapy for Obesity and Cardiometabolic Comorbidities (2026) · cites this paper as [2]
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Self-citationObesity and Weight Loss Medications
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- Authors
- Kong, Y., Yang, H., Nie, R., Zhang, X., Zuo, F., Zhang, H., & Nian, X.
- Affiliations
- First Affiliated Hospital of Kunming Medical University (CN)
- Kunming Medical University (CN)
- Corresponding author
- Zhang, Hongtao
- Nian, Xin
- Venue
- Molecular Biomedicine
- Published
- 2025-04-25
- Volume
- 6
- Issue
- 1
- Pages
- 25-25
- ISSN
- 2662-8651 (ISSN-L)
- PMC
- PMC12031720
- OpenAlex
- W4409818142
- Cited by
- 89
- References
- 499
- Citations by year
- 2026: 77 · 2025: 12
- FWCI
- 12.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Molecular Biomedicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Kunming Medical University (RLMY20220005, CXTD202209, 202201AY070001-066)
- Yunnan Provincial Science and Technology Department (202201AY070001)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Pharmacology › Berberine and alkaloids research
- Keywords
- obesity, obesity pathophysiology, adipose tissue expansion, chronic inflammation, neuroendocrine dysfunction, obesity-related comorbidities, type 2 diabetes, cardiovascular disease, non-alcoholic fatty liver disease, musculoskeletal impairment, psychological comorbidity, obesity pharmacotherapy, berberine, phytochemicals, weight management
- MeSH terms
- Animals, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Humans, Obesity, Anti-Obesity Agents, Non-alcoholic Fatty Liver Disease
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