[Incretins as the basis of obesity treatment]

Obesity represents an immense challenge for patients and physicians due to its numerous comorbidities and complications. For a long time, safe and effective pharmacological treatment remained wishful thinking. Bariatric surgery was considered the only option for sustained weight loss; however, with the advent of incretin-based treatment, initially introduced as a highly effective component of anti-diabetic treatment, research began to focus on the complex gastroenteropancreatic endocrine system, including central hunger and satiety regulation. This shift was driven by the discovery of a remarkable side effect: placebo-controlled weight reduction. Subsequent groundbreaking pharmacological developments based on long-acting peptides, the administration of which could be reduced from twice daily in earlier forms of treatment to once weekly, now enables significant weight reduction of over 20%, with a tolerable safety profile. This article provides an illustrative overview of the corresponding associations and highlights this milestone in obesity treatment.