Monitoring nutritional consequences of obesity treatment on long-term health of women and their offspring: protocol of a multicentre prospective cohort study.

INTRODUCTION: Over the past years, the number of people receiving surgical or pharmacological obesity treatment has been increasing globally. The majority of these patients are female and of reproductive age. Although these treatments are effective in reducing body weight and obesity-related comorbidities for most patients with obesity, they also compromise nutrient status, which may negatively impact the long-term health of women and their offspring born after obesity treatment. Hence, there is a need to investigate the nutritional consequences of obesity treatment and their long-term health effects on women and their offspring. METHODS AND ANALYSIS: The MOnitor the NUtritional Consequences of Obesity (MONUCO) study is a multicentre prospective cohort study with an integrated pregnancy and birth cohort. At least 1150 women living with obesity, undergoing either surgical or pharmacological obesity treatment, aged 18-55 years, will be included. Assessments will be performed pretreatment and post-treatment at 3 months, 6 months and yearly up to 10 years. Dietary intake, nutrient status, lifestyle factors and parameters related to musculoskeletal, reproductive, endocrine, gastrointestinal and mental health will be assessed. Data will be collected using physical measurements, questionnaires or biological samples, including urine, blood and faeces. In the pregnancy and birth cohort, pregnant women with a history of obesity treatment will be followed throughout and after pregnancy. In this cohort, additional information will be collected on nutrient status during pregnancy, foetal growth, child development and human milk composition. This observational study will provide comprehensive insights into the consequences of both surgical and pharmacological obesity treatment on nutrient status and dietary intake and consequent musculoskeletal health, maternal health and foetal growth. Based on these findings, more evidence-based nutrition recommendations to optimise long-term health for individuals treated for obesity can be developed. ETHICS AND DISSEMINATION: The MONUCO study is approved by the Medical Ethical Committee Oost-Nederland, Nijmegen, the Netherlands (NL86647.091.24). The results of this study will be disseminated in the form of scientific abstracts, posters, oral presentations at conferences and publications in peer-reviewed journals. Additionally, results may be made available to study participants and the general public via other platforms. TRIAL REGISTRATION NUMBER: NCT06945016. Registration was perfromed in the pre-results stage.