More than 800 million people worldwide who have obesity could potentially benefit from a hormone-mimicking medication typically used to treat diabetes. The medication is now shown to be effective for weight loss, says an expert at a top American hospital, Cleveland Clinic, ahead of World Obesity Day on March 4.
Dr W Scott Butsch, Director of Obesity Medicine, Cleveland Clinic’s Bariatric & Metabolic Institute, said: “Obesity is a complex, highly heritable disease with a strong biological basis. We estimate 40 to 70% of the variability of the BMI in the population is due to genetic traits, which makes it very challenging for people to lose weight. Treatment plans need to be personalised and include different approaches, such as lifestyle interventions, obesity medications, and bariatric and metabolic surgery. Importantly, the recent STEP 1 trial showing the beneficial impact of diabetes drug semaglutide on weight could be a game-changer in helping many people with obesity to lose a significant amount of weight.”
Semaglutide mimics the glucagon-like peptide-1 (GLP-1) hormone to increase insulin secretion and has been marketed as a drug for type 2 diabetes. The STEP 1 clinical trial of semaglutide saw the majority of patients with obesity lose at least 10% of their body weight, with one-third losing at least 20%.
Obesity is one of the world’s most prevalent diseases, with the United Nations estimating 800 million people have obesity worldwide. Another 40 million children are considered overweight.
People are classified as having obesity if their body mass index (BMI) is higher than 30, and at a higher metabolic risk if their waist circumference is above 89 cm for women or 102 cm for men. BMI is calculated by taking a person’s weight in kilograms and dividing this by the square of his/her height in meters.
Patients who have obesity are at higher risk for more than 220 medical conditions such as heart disease, stroke, high blood pressure (hypertension) and diabetes.
In terms of treating obesity, the medical establishment has moved on from measures such as drastic diets and energy pills to focus on treating obesity as a complex disease with multiple factors that need to be considered. Less serious cases may be treated by exercise, healthier diets, or certain medications that target pathways involved in weight regulation. People with more severe cases may need bariatric and metabolic surgery such as a gastric bypass or a sleeve gastrectomy, which could help them lose 20 to 40% of their body weight.
While there is not one cause for obesity, research points to a combination of genetic, environmental, and psychological factors, and, in some, may be caused by brain trauma or surgery. Environmental factors can include lack of physical activity, poor sleep, increased stress and not having access to healthy foods. Certain medications can cause weight gain. In rare cases, patients may have genetic mutations, for example with their leptin hormone, which regulates the body’s appetite.
“Obesity can develop across any population, any age group, and anywhere in the world – and we have to pay attention to it, especially in our children,” said Dr Butsch. “Because it is highly likely that those who develop obesity at an early age are likely to continue to have obesity as an adult.”
Dr Butsch adds that the complexities of the disease are compounded by societal pressures, and lack of research and understanding.
“Many patients who have obesity face stigma in body shaming from society, and also from their healthcare providers, public policies, and insurance coverage plans,” said Dr Butsch. “Obesity deserves greater levels of advocacy, research funding, and health insurance coverage.” — Tradearabia News Service