Advances in anti-obesity interventions

Obesity – an increasing public health issue that affects both children and adults. Given that both genetic and environmental factors influence obesity, effective management necessitates a comprehensive understanding of its genetic basis and lifestyle modifications. Insights into the genetics of obesity could facilitate the development of precision medicine approaches for anti-obesity treatments.

A recent review examined the prevalence of obesity and its associated health complications. It explored disruptions in energy balance as a characteristic of obesity and discussed evolutionary theories, multifactorial origins, and the heritability of the condition. The authors also addressed both monogenic and polygenic forms of obesity, the biological pathways involved, pharmacogenomic applications, and current anti-obesity medications, with a particular focus on the leptin-melanocortin and incretin pathways. Additionally, it compared the genetic factors influencing childhood and adult obesity and provided insights into structural genetic variants, epigenetic modifications, and environmental impacts on epigenetic markers.

Expert opinion suggests that advances in anti-obesity medications and genetic research have identified new therapeutic targets and allowed for repurposing existing drugs, presenting opportunities for genotype-based treatments. Lifestyle interventions – emphasizing a balanced and nutritious diet, physical activity, alcohol limitation, and quality sleep may help to overcome obesity by inducing alterations that impact the epigenetic markers. The genetic architecture of obesity shows significant overlap between adults and children – genetic studies have shown that monogenic and polygenic obesity point to the leptin-melanocortin pathway. Large-scale genetic studies with diverse ethnic groups are necessary to identify potential drug targets, repurposing existing drugs, and genotype-informed treatment strategies to prevent and overcome obesity.

Source: M JN, Bharadwaj D. Expert Rev Endocrinol Metab. Published online June, 2024.