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Objective: To describe the oral health status of patients with obesity and to explore the socio-demographic characteristics, comorbidities, lifestyle habits (tobacco, alcohol, sweet/acidic diet), and saliva parameters most associated with the dental caries experience.  Material and methods: We conducted a cross-sectional analysis of 204 patients' data with obesity attending a therapeutic education programme. Caries experience (number of decayed, missing, and filled teeth [DMFT]), periodontal status, oral hygiene, occlusal tooth wear, masticatory inefficiency, and saliva parameters were recorded., Results: Mean DMFT was 12 ± 7 and was independently associated with age (mean 47 ± 14 years; for 1 standard deviation (SD) increase: β = 0.22, 95% confidence interval [CI] = 0.16-0.29), female sex (72%; β = 3.76, 95% CI = 1.65-5.87), brushing <2 times/day (35%; β = 2.86, 95% CI = 0.81-4.90), salivary buffering capacity (low [46%] vs. normal [40%]: β = 2.02, 95% CI = 0.08-3.95; very low [10%] vs. normal: β = 3.34, 95% CI = 0.31-6.37), and salivary consistency (bubbly [30%] vs. clear [57%]: β = 2.45, 95% CI = 0.52-4.38)., Conclusions: Improving patients' competencies for oral care, such as teeth brushing twice daily, is necessary to limit the burden of dental caries in individuals with obesity. Acting on salivary composition may also be of interest, and further studies are required to explore the underlying mechanisms.

Introduction: Extreme obesity (BMI ≥50 kg/m2) is a complex pathology to treat. One of the complications of extreme obesity is massive localized lymphedema (MLL), due to compromised lymphatic drainage. There is a lack of literature guiding the medical management of these conditions., Case Presentation: We present a 43-year-old male who was admitted to our specialized obesity center for weight management. His initial weight was 255 kg and BMI was 93.7 kg/m2. He suffered from massive multifocal lymphedema of his left leg. He was bedridden due to his condition and malnourished, as shown by multiple vitamin deficiencies. The patient received care from our multidisciplinary team including nurses, dieticians, physical therapists, and psychologists. Treatment with semaglutide was started in hospital and continued at home. The maximal dose used was 1 mg/week but decreased during follow-up to 0.25 mg/week to avoid malnutrition. Protein and nutritional supplements were added. At 28 weeks of therapy, the patient had lost 40 kg or 15.7% of his total body weight. His lymphedema decreased; he had lost at least 16 cm of his left thigh circumference. He was able to walk again and regain autonomy of his daily activities of living., Conclusion: Semaglutide can be effective in patients with extreme obesity, with the support of a multidisciplinary team in a specialized obesity center. It can also help decrease MLL. More data are needed to guide medical treatment of patients with extreme obesity and MLL., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

Bariatric surgery is routinely proposed to patients suffering from obesity including kidney transplant recipients. In this specific population, bariatric surgery has a positive impact in long-term outcomes in terms of patient and graft survival. We report here the cases of 4 patients with five post-kidney transplantation bariatric surgeries who experimented acute renal injury early after surgery. Creatinine rising occurred between day 14 and day 20 after surgery. In all cases, it was due to dehydration leading to a pre-renal acute renal failure. The specific care of kidney transplanted patients is discussed: single kidney associated with pre-existing altered kidney function associated with concomitant use of nephrotoxic drugs. Specific education intervention before surgery associated with careful early management of hydration after surgery is mandatory for these patients., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Mutations in genes encoding proteins located in the leptin/melanocortin pathway have been identified in the rare cases of genetic obesities. Heterozygous variants of MRAP2, encoding a G coupled-protein receptor accessory protein implicated in energy control notably via the melanocortin-4 receptor, have been recently identified. A 24-year-old patient with early-onset severe obesity (body mass index [BMI]: 64 kg/m2) associated with hypertension, respiratory complications, nonalcoholic fatty liver disease, and type 2 diabetes was referred to our department. Sleeve gastrectomy was successful. A new heterozygous variant in MRAP2 (NM&#95;138409.4: c.154G>C/p.G52R) variant was identified in the patient DNA. Functional assessment confirmed that this new variant was pathogenic. We report a new pathogenic loss-of-function mutation in MRAP2 in a patient suffering from a severe multicomplicated obesity. This confirms the metabolic phenotype in patients with this monogenic form of obesity. Longer follow-up will be necessary. Our finding will allow a personalized medicine., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)