Obesity therapeutics: The end of the beginning

Fiona M Gribble1, Stephen O'Rahilly1

  • 1WT-MRC Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.

Cell Metabolism
|April 7, 2021
PubMed

Insights

Semaglutide, a GLP-1 receptor agonist, helped obese patients lose and maintain approximately 15% of their body weight for over a year. This indicates a new era for hormone-based anti-obesity medications targeting brain functions.

Area of Science:

  • Endocrinology
  • Pharmacology
  • Obesity Medicine

Background:

  • Obesity is a complex chronic disease with limited effective long-term treatments.
  • Hormonal pathways regulating appetite are key targets for weight management.

Purpose of the Study:

  • To evaluate the efficacy and durability of semaglutide in promoting weight loss in obese non-diabetic individuals.
  • To assess the impact of semaglutide on body weight maintenance over an extended period.

Main Methods:

  • A large-scale, randomized, placebo-controlled clinical trial.
  • Administration of injectable semaglutide, a long-acting glucagon-like peptide-1 (GLP-1) receptor agonist.
  • Long-term follow-up exceeding one year.

Main Results:

  • Participants achieved and sustained an average body weight loss of approximately 15%.
  • Significant and maintained weight reduction was observed throughout the study duration.
  • Semaglutide demonstrated robust efficacy in long-term weight management.

Conclusions:

  • Injectable semaglutide is a highly effective therapeutic option for significant and sustained weight loss in obese individuals.
  • These findings support the development of GLP-1 receptor agonists as a new class of anti-obesity drugs.
  • Hormone-based therapies acting on central appetite regulation represent a promising future for obesity treatment.

Related Concept Videos

Obesity01:24

Obesity

The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
880
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
70
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
51
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion01:20

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...
62
Diabetes: Management and Pharmacotherapy01:15

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
678
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists

Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
273