In 2025, obesity diagnosis and management entered a new stage characterized by disease stratification and long-term care. Focusing on six key topics: obesity classification, clinical guidelines, novel pharmacotherapies, comorbidity management, weight management clinics, and nutrition labeling, this paper summarizes the major advances in obesity research and practice worldwide in 2025. The Lancet Diabetes and Endocrinology Commission proposed a new framework distinguishing pre-clinical obesity and clinical obesity. American Association of Clinical Endocrinology (AACE), European Association for the Study of Obesity (EASO), and WHO further emphasized that treatment should be determined by obesity-related complications and functional impairment. Tirzepatide, mazdutide, oral GLP-1 receptor agonists, and multi-target agents have propelled anti-obesity medications into an era of high efficacy and diversification. The management of obesity-related comorbidities and diseases, including type 2 diabetes, heart failure with preserved ejection fraction, metabolic dysfunction-associated steatohepatitis, osteoarthritis, and obstructive sleep apnea, has become a clinical priority. China is concurrently advancing the establishment of standardized weight management clinics and the implementation of digital labeling for pre-packaged foods, marking a strategic shift in obesity management from purely clinical treatment toward integrated prevention and care. This paper aims to provide an annual reference for clinical research, specialty development, and practice in the field of obesity for the year 2026.
Obesity is a major global public health challenge. Although intensive lifestyle intervention can induce weight loss, its effectiveness is often constrained by eating behaviors. Existing behavior-focused interventions show limited efficacy. New approaches that can improve eating behaviors are needed to enhance the weight-loss efficacy of intensive lifestyle intervention.
To evaluate the effects of Xiere Xingpi Yin on eating behaviors and weight-related outcomes in adults with obesity.
A total of 108 adults with obesity seen at the Endocrinology Department of Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, from March 2022 to March 2024 were randomized (1∶1) to an experimental group (n=54) and a control group (n=54) using simple randomization. Both groups received a 12-week intensive lifestyle intervention; in addition, the experimental group was given Xiere Xingpi Yin granules and the control group received placebo granules. At 12 weeks, between-group comparisons were made for eating behaviors—cognitive restraint, uncontrolled eating, and emotional eating; weight-related outcomes—change in body weight and BMI, and the proportions achieving≥5% and≥10% body-weight loss; body fat distribution; inflammatory markers; and glycemic and lipid indices. Adverse events were monitored throughout. Data analysis used the full analysis set (FAS) as the primary analysis set, following the intention-to-treat (ITT) principle. Sensitivity analyses for dietary behaviors and weight loss efficacy were conducted using the per-protocol set (PPS).
A total of 93 patients completed the trial, with 42 in the control group and 51 in the experimental group. There were no statistically significant differences in baseline characteristics, including body weight, BMI, prior weight-loss history, and psychological status (P>0.05). At 12 weeks, the experimental group showed better eating-behavior outcomes, with lower endpoint scores for cognitive restraint [(12.9±3.2) points vs (14.3±3.8) points] and uncontrolled eating [(16.5±4.9) points vs (18.9±6.2) points] than the control group (P<0.05). The proportion of patients with ≥5% body-weight loss in the trial group [90.7% (49/54) vs 50.0%(27/54) ] and the proportion with ≥10% body-weight loss [(35.2%(19/54) vs 9.3%(5/54) ] were higher than in the control group (P<0.05), and reductions in body weight [(8.7±3.6) kg vs (5.1±3.0) kg] and BMI [(3.1±1.2) kg/m2 vs (1.8±1.0) kg/m2] were greater (P<0.05). The sensitivity analyses showed that the results from the PPS were consistent with those from the FAS for all the aforementioned endpoints. In addition, improvements in body fat distribution, inflammatory markers, glycemic and lipid indices, and TCM syndrome-factor scores were greater in the experimental group (P<0.05). The incidence of adverse events did not differ between the two groups [11.1% (6/54) vs 9.3% (5/54), χ2=0.091, P>0.05].
Xiere Xingpi Yin improved eating behaviors, and thereby enhanced the weight-loss efficacy of intensive lifestyle intervention. It also produced coordinated benefits in body fat distribution, inflammation, and glycemic and lipid indices, with a favorable safety profile. Xiere Xingpi Yin may serve as an adjunctive TCM option to improve eating behaviors and strengthen body-weight management.
Against the backdrop of the escalating prevalence of overweight and obesity, China has promulgated numerous weight management policies. However, the selection preferences, compositional structure, and stakeholder coupling characteristics of the policy instruments employed remain to be systematically analyzed.
To systematically analyze the selection preferences and compositional characteristics of policy instruments for weight management in China, identify structural imbalances within the current policy system, and provide evidence-based references for optimizing the nation's comprehensive obesity prevention and control strategies.
In November 2025, eleven core national-level policy documents on weight management issued from January 1, 2016 to October 31, 2025 were selected as the study objects. A "policy instrument-stakeholder" two-dimensional analytical framework was constructed, and content analysis was employed to conduct systematic coding, frequency statistical analysis, and cross-analysis of the policy texts.
A total of 454 policy instrument codes and 538 stakeholder codes were extracted from 11 core policy documents. Command-and-control instruments had the highest proportion [182 (40.09%)], followed by information-based [101 (22.25%)] and capacity-building instruments [91 (20.04%)], while incentive-based [43 (9.47%)] and system-change instruments [37 (8.15%)] accounted for relatively low proportions. In the stakeholder dimension, government departments [204 (37.92%)] and healthcare institutions [139 (25.84%)] were the primary targets, while health-related industries [34 (6.32%)] and social organizations [39 (7.25%)] received relatively low policy attention.
China's weight management policy system exhibits significant structural imbalances in instrument configuration, presenting a "center-periphery" governance structure centered on administrative leadership and medical intervention. The intervention logic prioritizes micro-level individual behavior regulation and health education, with insufficient attention given to structural interventions regarding the obesogenic environment and multi-stakeholder coordination mechanisms. There is an urgent need to address deficiencies in fiscal incentives and legal regulations, strengthen inter-sectoral coordination and social mobilization mechanisms, and promote the transformation of the policy system toward legalization, incentivization, and collaborative governance.
