Hormonal
Bariatric surgery (RYGB/VSG) provides superior sustained weight loss (13-27%) and T2D remission compared to pharmacological interventions, largely driven by endocrine changes rather than just mechanical restriction.
Bariatric surgery (like gastric bypass) is currently the most effective treatment for obesity, achieving 13-27% sustained weight loss and often curing type 2 diabetes. Its success is driven by hormonal changes (increased GLP-1/PYY) rather than just stomach size reduction. However, due to its invasive nature, it is reserved for extreme cases, driving the need for drugs that can mimic these hormonal effects.
Bariatric surgery is rapidly gaining in popularity, and large-scale follow-up studies dependent on the surgical procedure, demonstrating sustained weight loss of 13%–27%, with follow-up for as much as 15 years... The improvement of metabolic control cannot be singularly justified by the physical limitation in gastrointestinal uptake of food, and notably glucose metabolism is typically improved much before a meaningful decrease in body weight is observed.
Why this rating
Cites large-scale follow-up studies with 15-year data and consistent remission of T2D.
Source
Anti-Obesity Therapy: from Rainbow Pills to Polyagonists
Timo D. Müller et al. · Pharmacological Reviews · 2018
DOI 10.1124/pr.117.014803
More from this paper
- Unimolecular polyagonists (e.g., GLP-1/Glucagon dual agonists) achieve superior weight loss and glycemic control compared to monoagonists or historical single-target therapies by combining anorectic and thermogenic effects.Good
- Historical weight-loss drugs (Thyroid hormones, DNP, Amphetamines) failed due to narrow therapeutic windows and severe adverse effects, despite some efficacy.Good
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- 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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