Recent advances in clinical practice challenges and opportunities in the management of obesity

Abstract

Despite advances in understanding the roles of adiposity, food intake, gastrointestinal and adipocyte-related hormones, inflammatory mediators, the gut-brain axis, and the hypothalamic nervous system in the pathophysiology of obesity, the effects of different therapeutic interventions on those pathophysiological mechanisms are controversial. There are still no low cost, safe, effective treatments for obesity and its complications. Currently, bariatric surgical approaches targeting the gastrointestinal tract are more effective than non-surgical approaches in inducing weight reduction and resolving obesity-related comorbidities. However, current guidelines emphasize non-surgical approaches through life-style modification and medications to achieve slow weight loss, which is not usually sustained and may be associated with medication-related side effects. This review analyzes current central, peripheral, or hormonal targets to treat obesity, and addresses challenges and opportunities to develop novel approaches for obesity.

Long-Term Effects of Bariatric Surgery on Type II Diabetes, Hypertension and Hyperlipidemia: A Meta-Analysis and Meta-Regression Study with 5-Year Follow-Up

“…Obesity can be treated non-surgically or by means of metabolic/bariatric surgery [9,10], which has been widely demonstrated to lead to sustained weight loss and a reduction in comorbidities [11][12][13][14], including type II diabetes, hypertension and hyperlipidemia [15,16]. There is increasing evidence that metabolic/bariatric surgery is a valid means of obtaining long-term weight control [17], and the current guidelines recommend it for subjects with a body mass index of >40 (>35 if related to one or more comorbidities) [18,19].…”

Fighting with obesity: the "gold standard" and new horizons

“…Так, 5-HT2c рецепторы играют важную роль в контроле над приемом пищи. Лорказерин -высоко спе-цифичный агонист 5-HT2c рецепторов, применяемый для лечения пациентов с ожирением в Европе и США [16].…”

“…Длительно действующие агонисты ре-цепторов GLP-1 используются в лечении СД 2 типа бо-лее 10 лет. Для лечения ожирения недавно был одоб-рен длительно действующий аналог GLP-1 -лираг-лютид [16].…”

Effect of Bariatric Surgery on Hypertension

“…Obesity can be treated non-surgically or by means of metabolic/bariatric surgery [4,5], which has been widely demonstrated to lead to sustained weight loss and a reduction in comorbidities [6][7][8][9].…”