Hormonal
Gut hormone-based pharmacotherapies (GLP-1RAs, amylin analogues, and multi-agonists) produce clinically significant weight loss (≥10-15%) and improve cardiometabolic health, effectively closing the treatment gap between lifestyle interventions and bariatric surgery.
For individuals with obesity who have not achieved sufficient weight loss through lifestyle changes alone, gut hormone-based medications (like semaglutide or tirzepatide) offer a clinically effective treatment option that can produce 10-15% or more weight loss. These treatments work by targeting the body's natural appetite-regulating systems, mimicking the effects of bariatric surgery to a degree, and improving metabolic health. While side effects like nausea are common, they often subside with dose titration, and new oral formulations are emerging to address injection aversion.
Scientific advancements have revealed the potential of therapeutic modification of gut peptides that modulate neural signalling involved in body weight regulation. The translation of the scientific understanding of body weight regulation has resulted in new anti-obesity medications that engender ≥10 % weight loss and are closing the treatment gap.
Why this rating
Based on multiple Phase 3 randomized controlled trials (STEP, SURPASS, SCALE) cited in the review.
Source
A new era in gut hormone-based pharmacotherapy for people with obesity
Chloe Firman et al. · Proceedings of The Nutrition Society · 2022
DOI 10.1017/s0029665122002695
Related findings · Hormonal
- Initial treatment for type 2 diabetes should be a combination of metformin and either an SGLT-2 inhibitor or a GLP-1 receptor agonist to achieve cardiorenal protection, rather than monotherapy or older agents like sulfonylureas.Strong
- For patients with specific monogenic obesity syndromes (leptin deficiency, POMC/PCSK1/LEPR mutations), targeted pharmacotherapy (recombinant leptin or setmelanotide) is highly effective and should be prioritized, unlike in polygenic obesity.Strong
- Continued weekly administration of 2.4 mg subcutaneous semaglutide prevents weight regain and promotes further weight loss in adults with overweight or obesity, whereas switching to placebo results in significant weight regain.Strong
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