摘要

Objectives: Obesity management and aesthetic optimisation remain challenging due to heterogeneous responses to dietary, endoscopic, and surgical interventions. We aimed to evaluate how specific genetic markers modulate weight loss outcomes and to investigate multi-locus interactions and functional pathways to refine patient selection and intervention strategies. Introduction: Genetic predisposition influences not only baseline obesity risk but also variability in treatment response across different weight loss modalities. Moving beyond single-gene associations, integrative analyses of SNPs, interactions, and enriched biological pathways may enhance clinical predictability, improving both health and aesthetic outcomes after intervention. Materials / method: A cohort of 9,372 patients was genotyped for a 102-SNP panel related to BMI and metabolic regulation. Of these, 474 underwent monitored interventions: dietary modification, intragastric balloon, or bariatric surgery. Association analyses were performed in R using the SNPassoc package, under multiple inheritance models and adjusted for covariates (age, sex, BMI, and intervention type). SNP–SNP interaction testing and STRING-based functional discovery were applied to highlight converging biological pathways relevant to treatment response. Results: Significant associations were identified for variants in FTO, MCM6, HLA, MC4R, PPAR-δ, and ACSL5 with baseline BMI and weight loss response (p<0.01). FTO and MCM6 predicted higher BMI, while PPAR-δ and ACSL5 were linked to favourable weight reduction across interventions. MC4R variants strongly stratified outcomes in surgical and endoscopic procedures, while ABCG8 and CYP1A2 influenced dietary response. Interaction analyses revealed epistatic effects between metabolic and appetite-regulation genes, increasing predictive accuracy. Pathway enrichment indicated convergence in lipid metabolism, in Conclusion: A 102-SNP genetic framework enhances the precision of weight loss intervention planning by integrating single-locus, interaction, and pathway-level insights. Genetic profiling supports more effective patient stratification, optimises surgical and non-surgical outcomes, and improves long-term satisfaction in aesthetic practice. Broader validation is warranted to consolidate these findings into routine protocols for precision weight management.