Hormonal
Exogenous GLP-1 receptor agonists (GLP-1RAs) induce significant weight loss (up to 25% of body weight) and improve glycemic control in type 2 diabetes by mimicking the endogenous 'ileal brake' mechanism, primarily through central nervous system appetite suppression and delayed gastric emptying.
GLP-1 receptor agonists are highly effective treatments for obesity and type 2 diabetes, capable of producing weight loss comparable to bariatric surgery. They work by leveraging the body's own hormonal pathways (specifically GLP-1) to reduce appetite and improve blood sugar control. While natural GLP-1 is short-lived and ineffective as a therapy, stabilized analogs overcome this. Patients should expect potential initial gastrointestinal side effects, which are managed by starting with low doses and increasing slowly.
Indeed, the most recent agonists may near-normalize glycaemic control in type 2 diabetes, may cause weight losses of up to 25% of body weight, and significantly reduce cardiovascular risk, effects that resemble those of bariatric surgery.
Why this rating
Based on a review of decades of physiological studies, clinical trials, and the author's foundational research.
Source
Annual Prize Lecture 2024: Endogenous physiological mechanisms as basis for the treatment of obesity and type 2 diabetes
Jens J. Holst · The Journal of Physiology · 2024
DOI 10.1113/jp287461
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