Ten reasons gastroenterologists and hepatologists should be treating obesity

Camilleri, Michael; El-Omar, Emad

doi:10.1136/gutjnl-2023-329639

Cited by 8 publications

(2 citation statements)

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“…Therefore, it is of paramount importance to use the success observed during efficacious pharmacological treatment of obesity to establish longer-term diet and lifestyle changes, and possibly additional pharmacological or other bariatric interventions, to impact this disease. In addition, given the multiple manifestations of obesity in gastrointestinal and hepatic diseases, as well as the fact that many of the novel approaches in addition to interventions with bariatric procedures target the gastrointestinal tract, it is strongly recommended that gastroenterologists and hepatologists should be treating obesity (Camilleri & El-Omar, 2023).…”

Section: Discussionmentioning

confidence: 99%

Newer pharmacological interventions directed at gut hormones for obesity

Camilleri,

Acosta

2023

British J Pharmacology

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The objective is to review the newer pharmacological interventions for obesity, specifically single, dual, and triple incretin receptor agonists that are either available or in the pipeline for treatment of obesity. The three incretin receptor targets are glucagon like peptide‐1 (GLP‐1), glucose‐dependent insulinotropic peptide (GIP), and glucagon. There are several approved single or dual incretin agonists which are administered subcutaneously daily (e.g., liraglutide) or weekly (e.g., semaglutide, dulaglutide, and exenatide QW), and experimental dual or triple incretin agonists. Other analogs of amylin, peptide YY, and oxyntomodulin, as well as a combination GLP1R agonist and GIPR antagonist are also being developed. Oral semaglutide (administered daily) is approved for type 2 diabetes and is on track for regulatory review for obesity. The review includes specifically perspectives on the effects of these mechanisms and pharmacological agents on gastric emptying which contribute to satiation and weight loss, in addition to the established evidence on effects on central mechanisms controlling appetite. In the future, it is anticipated that small molecule GLP‐1 receptor agonists (e.g., oral danuglipron) will be developed. These pharmacological agents are having significant impact on glycemic control and obesity and their co‐morbidities.

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Section: Discussionmentioning

confidence: 99%

Newer pharmacological interventions directed at gut hormones for obesity

Camilleri,

Acosta

2023

British J Pharmacology

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“…Gastroenterologists and hepatologists should be aware of the opportunities to treat obesity when patients present to their clinics (1) and of the adverse effects of obesity medications. The objectives of this review are to summarize the mechanisms of action of incretin receptor agonists (RAs), their effects in the gastrointestinal tract, and the clinical practice implications associated with their use in the practice of gastroenterology, endoscopy, and surgery.…”

Section: Introductionmentioning

confidence: 99%

Effects of GLP-1 and Other Gut Hormone Receptors on the Gastrointestinal Tract and Implications in Clinical Practice

Camilleri,

Lupianez-Merly

2023

Am J Gastroenterol

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Agonists targeting the receptors of incretin hormones, glucagon like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide, have been well established for the treatment of type 2 diabetes mellitus. There is increasing awareness that gastroenterologists and hepatologists should be treating obesity when patients present to their clinics. In addition, gastroenterologists and hepatologists should be aware of the effects of these classes of medications prescribed by other providers. Therefore, given the widespread use of incretin agonists for obesity treatment and weight loss, it is important to recognize their effects in the gastrointestinal tract, which could constitute significant benefits in weight loss and cardiometabolic benefits, but can be associated with adverse effects that constitute a potential barrier to their use, particularly at higher doses. Multiple studies reviewed in this article document the diverse effects of these drugs on the GLP-1 receptors that are widely expressed in the human body, including the nervous system modulating appetite, the gastrointestinal tract modifying gastric emptying, and lipid metabolism regulation leading to reduction in fat deposition. The objective of this review is to summarize the mechanism of action of incretin receptor agonists, their effects in the gastrointestinal tract, and implications in clinical practice, particularly in the practice of gastroenterology, endoscopy, and surgery.

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