ENDO 2025 mines endocrine breakthroughs and breakouts in San Francisco
When the biggest endocrinology conference in the world happens, professionals from around the world take notice! Over 7,000 endocrinologists from around the world hit the jackpot in San Francisco the second week in July for ENDO 2025 where there more than just a few “eureka moments!
People have always sought this place. Gold was discovered here in 1848 and so people came. San Francisco – once hailed as the “Paris of the West” soon after became a mecca for artists and scientists. And San Francisco has been through a lot. Earthquakes, fires, naked corruption. But this is a city about connections. No matter the tumult in the city, it seems like this desire to be together remained strong. Sure, they came for the gold, but they stayed for the community. The iconic San Francisco cable cars continue to bring the city together, carrying locals and tourists alike around the city, wherever they want to go. San Francisco’s cable car system is the last manually operated one in the world.
Endocrinologists are good at making connections – solving the puzzle. How is loneliness connected to an increased risk of diabetes? How might parents’ emotional health affect their child’s growth? ENDO 2025 had answers to these questions, and a lot more.
Social Isolation May Heighten Risk of Diabetes in Older Adults
The COVID-19 pandemic reshaped the world in many ways, and here, five years from the outset, the healthcare community is still uncovering the results of the disease’s devastation. A study presented at ENDO 2025 by Samiya Khan, MD; Farhaad Khan, MD; and Alyssa Lampe Dominguez, MD, all of the Keck School of Medicine at the University of Southern California, found that socially isolated older adults are at increased risk of developing diabetes and high blood sugar. The authors note that social isolation and loneliness are increasingly recognized as health risk factors after the COVID-19 pandemic.
“Our findings underscore the importance for clinicians to recognize social isolation as a critical social determinant of health when caring for older patients,” says Samiya Khan. “These findings are especially relevant given the rapidly growing aging population in the United States and globally, alongside the widespread prevalence of social isolation and loneliness among older adults.”
For this cross-sectional study, the researchers examined the association of social isolation and diabetes in U.S. adults aged 60 to 84, using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2008. The researchers studied data from 3,833 adults; the population cohort represents about 38 million people in the U.S. “Participants were categorized as having diabetes based on self-report,” the authors write. “Poor glycemic control was defined as having an A1c >8%. Covariates included sociodemographic factors, smoking, alcohol, BMI, physical activity level, hypertension, and hyperlipidemia.”
After adjusting for other factors, they found that socially isolated older adults were 34% more likely to have diabetes and 75% more likely to have poor blood sugar control than those who were not isolated, suggesting that social isolation may be an important but often overlooked risk factor for diabetes and poor blood sugar management in older adults.
“These findings underscore the importance of social connections for the wellbeing of older adults,” the authors conclude. “Physicians should recognize social isolation as a potential risk factor among elderly patients for both diabetes and hyperglycemia. Because this study was cross-sectional, future prospective research is needed to examine causal relationships and temporality.”
Consuming More Protein May Protect Against Muscle Loss from Anti-Obesity Meds
Anti-obesity medications like semaglutide have made all kinds of headlines in the past couple of years – a blockbuster drug, not just for people with obesity, but the medical community is finding benefits of the glucagon-like peptide-1 receptor agonist (GLP-1 RA) in even alcohol use disorder. The U.S. Food and Drug Administration just approved semaglutide to treat metabolic dysfunction–associated steatohepatitis (MASH).
But the drug, for all its benefits, isn’t without its drawbacks. According to a study presented at ENDO by Melanie Haines, MD, of Massachusetts General Hospital and Harvard Medical School in Boston, losing muscle – lean mass — is a common side effect of weight loss in adults with obesity and may negatively affect metabolism and bone health. About 40% of the weight lost secondary to semaglutide is lean mass, write Haines and her co-authors. “However,” the authors go on to write, “predictors of muscle loss in this population are unknown, as are the effects of muscle loss on glucose and bone homeostasis.”
For this study, the researchers studied 40 adults with obesity for three months. Of these patients, 23 were prescribed semaglutide, while 17 followed a diet and lifestyle program for weight loss called Healthy Habits for Life (HHL). The researchers evaluated how their muscle mass changed.
Study participants who were prescribed semaglutide lost more weight than those who participated in the diet and lifestyle program, but the percentage of weight loss that was lean mass was similar between the two groups.
After accounting for weight loss, the researchers found that in the semaglutide group, being older, female, or eating less protein was linked to greater muscle loss. Also in this group, losing more muscle was linked to less improvement in blood sugar (HbA1c levels). “Change in lean mass was more strongly correlated with change in weight in the HHL vs. semaglutide group,” the authors write. “Lower protein intake at three months in the semaglutide group and older age in the HHL group were associated with a greater decrease in lean mass.”
“Older adults and women may be more likely to lose muscle on semaglutide, but eating more protein may help protect against this,” Haines says. “Losing too much muscle may reduce the benefits of semaglutide on blood sugar control. This means preserving muscle during weight loss with semaglutide may be important to reduce insulin resistance and prevent frailty in people with obesity.”
The researchers also looked at semaglutide’s effect on bone mineral density but write that the association between semaglutide and bone metabolism warrants further investigation.
“In conclusion, older age and female sex may be associated with greater muscle loss, while higher protein intake may be relatively protective against muscle loss, in adults with obesity prescribed semaglutide,” the authors write. “Greater muscle loss was independently associated with less improvement in glucose homeostasis with semaglutide. Therefore, maintaining muscle mass with weight loss in individuals with obesity on semaglutide may be essential to mitigate insulin resistance and frailty.”
Early-Life Exposure to Endocrine-Disrupting Chemicals May Influence Food Preference
The endocrine-disrupting chemicals (EDCs) termed obesogens have of course been well-studied for their effects on adipogenesis, but as Emily N. Hilz, PhD, a postdoctoral research fellow at the University of Texas at Austin in Austin, Texas, and her co-authors point out in their presentation at ENDO 2025, these chemicals’ impact on the brain remain unexplored, particularly within the brain reward system. [Hilz presented this research during the Rising Star Power Talks at ENDO 2025 and was designated the Basic Science Award winner for her presentation, and was featured in the August issue’s “Star Power 2025” roundtable.]
To determine if early-life exposure to these chemicals affects eating behaviors and preferences, researchers from the University of Texas at Austin conducted a study of 15 male and 15 female rats exposed to a common mixture of these chemicals during gestation or infancy. “In the current study, male and female rats were exposed perinatally to a mixture of obesogenic and neurodevelopmentally disruptive EDCs termed “NeuroMix” (NMX),” the study authors write. “Developmental measures were tracked throughout life, and in adulthood, rats underwent a battery of behavioral tests to assess preference for highly rewarding foods including high-fat diet and sucrose solution.”
Findings showed that male rats with early-life exposure to endocrine-disrupting chemicals had a temporary preference for the sucrose solution, while female rats showed a strong preference for high-fat food that resulted in weight gain. In addition, testosterone was reduced in exposed males, while estradiol in females remained unchanged.
“Targeted 3’ RNA sequencing (TAGseq) was then performed in the brain reward system,” the authors write. “NMX induced sex-specific changes in gene expression across regions of the brain that support reward processing and feeding behavior; using Gene Ontology (GO), the functional significance of these changes related primarily to processes involved in epigenetic regulation (e.g., chromatin remodeling, histone modification, and DNA methylation) and transcriptional activity.”
During the study, areas of the brain were sequenced to determine if early-life exposure to endocrine-disrupting chemicals resulted in physical changes to the regions important to controlling food intake and responding to reward. Researchers observed changes to gene expression throughout all areas sequenced in male rat brains, and varying changes to gene expression in the region of female rat brains associated with reward. These physical changes were predictive of changes to eating behavior and food preferences.
“These processes were downregulated in the lateral hypothalamus and ventral tegmental area of NMX-exposed males, and upregulated in the nucleus accumbens of both sexes,” the authors write. “Weighted gene co-expression analysis was used to correlate neuromolecular changes with behavioral outcomes, suggesting that molecular disruptions in the brain reward and metabolic systems drive obesogenic EDC effects.”
“Our research indicates that endocrine-disrupting chemicals can physically alter the brain’s pathways that control reward preference and eating behavior. These results may partially explain increasing rates of obesity around the world,” Hilz says. “Understanding the harmful health impact that exposure to these types of chemicals can have on eating patterns may help inform public health recommendations and personal efforts to improve diet-related health complications.”
Emotional Health of Parents Tied to Well-Being of Children with Growth Hormone Deficiency
Strong emotional links between children with chronic conditions and their family caregivers suggest that improving parent well-being may directly benefit a child’s overall health and coping mechanisms.
Luis Fernandez Luque, PhD, chief scientific officer and co-founder of Adhera Health in Santa Cruz, Calif. presented results from a study that observed children with growth hormone deficiency (GHD) and their caregivers to better understand the impact that physical or emotional distress can have.
“Fifty caregivers of children with GHD completed a three-month digital program aimed at supporting their well-being,” the authors write. “In this study, we focused on the psychometric questionnaires completed by the caregivers. Associations between caregiver and child well-being were analyzed using Spearman’s correlation.
“Specifically, items addressing the emotional and physical state of the children were among those strongly associated with caregiver well-being,” the authors continue. “For instance, children feeling sadder had parents feeling more stress and anxiety, while caregivers’ negative affect was higher when they felt their children were being treated unfairly.”
Findings indicated that a child’s emotional and physical health are strongly correlated with caregiver well-being. Greater child distress, such as negative feelings about treatment or difficulty coping with growth hormone deficiency, was associated with higher caregiver stress, anxiety, and depressive symptoms. Caregiver hopefulness about the future was linked to better emotional outcomes in the child.
“This research confirms the well-being of children with chronic conditions is inseparable from the emotional health of their caregivers,” says Ricardo C. Berrios, CEO and co-founder of Adhera Health, who was a co-author of the study. “Adhera’s AI-powered platform was designed from the ground up to support this dynamic, combining behavioral science and responsible AI to empower families — not just patients. These findings strengthen our conviction that improving outcomes for children requires an ecosystem approach, one that puts caregivers at the center of pediatric chronic care.”
“This study underscores the strong relationship between child and caregiver well-being in families managing GHD,” the authors conclude. “Children’s emotional and physical challenges are closely linked with caregiver mental health, as well as children’s coping and treatment experiences. These findings emphasize the need for family-centered interventions to support both children and caregivers, improving outcomes for families managing GHD.”
Once again, ENDO proved to be rich with knowledge for endocrine scientists, clinicians, educators, researchers, students, and more, all who journeyed to the Gold Coast to seek their own fortune. This time, instead of departing with carts of shining ore that would only take them so far, ENDO 2025 attendees departed The Golden City equipped with new knowledge from the greatest scientific minds from around the world.
And next June it will happen all over again in Chicago, Ill., for ENDO 2026!
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