New drugs are emerging against the increase in obesity in the world

A constant target of quacks, obesity does not result from a lack of willpower, is difficult to treat and deserves medical monitoring

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We are facing a new era in the fight against obesity, with the emergence of new weight-loss drugs, a major advance in science. But before optimism takes over from reality, can the medicalization of obesity put a definitive end to the world’s obesity epidemic?

“Obesity is a serious public health problem and many patients, even by changing their diet and lifestyle, are unable to reach their ideal weight for genetic reasons. In this way drugs can be excellent allies. In these cases genetics is supreme, so there is no cure. Some patients will need lifelong care. Not necessarily a lifetime of medications, but medical, nutritional, psychological monitoring and, if applicable, alternative therapy,” she explains. Debora Berangerendocrinologist, with a specialization in Endocrinology and Metabology at the Santa Casa de Misericórdia do Rio de Janeiro (SCMRJ).

Factors causing obesity

Deborah Beranger, a specialist in this type of treatment and with an in-depth course on obesity at Harvard Medical School, explains that genetics, ultra-processed foods, portion distortion, sugary drinks, time spent in front of the screen , food addiction, gut microbiota, diet culture, weight stigma, food insecurity – in short, many factors impact the current obesity epidemic seen around the world.

“More than a billion people in the world are obese and many others are overweight,” explains the doctor.

Obesity, profitable for the food industry, the target of constant quackery and wrongly attributed to lack of willpower, has a recent history as a disease. Only in 2013 did the American Medical Association, one of the most influential medical organizations in the world, decide to classify it as a disease.

Since then, not everything has gone right: the condition has remained in the realm of charlatans and bad professionals, especially with the advancement of social networks, which have given rise to an infinite number of profiles that give restrictive advice on weight loss and encourage compulsion.

Advances in the study of obesity

Deborah explains that the study of obesity has made a lot of progress in recent years.

“However, until now, Medicine has had little to offer. From dinitrophenol (cataracts and fatal hyperthermia) to fenfluramine-phentermine (valvular heart disease) to orlistat (fecal leakage), promising weight-loss drugs have been withdrawn or avoided due to adverse effects. Bariatric surgery has become routine, but it is neither benign nor universally effective,” explains the endocrinologist.

“The weight cycle has taken a toll on bodies and minds, with the emergence of eating disorders attributed to repeated episodes of calorie restriction and appetite recovery. Doctors begged patients to lose weight, but offered few effective tools,” he explains.

In 2023, the World Obesity Foundation predicted that the global economic impact of overweight and obesity will reach $4.3 trillion by 2035, if current trends continue.

“The personal cost is also enormous. Unlike many chronic diseases, obesity is visible. People try everything to lose weight: diets, weight loss and exercise programs, psychotherapy, devices and surgery. The feeling of failure generates greater stress, anxiety and mental health problems. Even medicine had to look with greater empathy at this patient who was discriminated against and suffered from feelings of personal guilt, often attributed by society”, says Deborah.

Medicine against obesity

Gradually, doctors incorporated practical advice to try to improve patients’ health. But now is the time to medicalize obesity.

“Neuroscientists have mapped the brain’s hunger and satiety circuits to genetically defined neurons whose activation can promote or inhibit eating in animals. Unraveling the biology of glucagon-like peptide 1 (GLP-1) has enabled the development of GLP-1 receptor agonists, initially to treat type 2 diabetes, but now revolutionizing the treatment of obesity. By delaying gastric emptying and promoting and prolonging satiety signals from the gut to the brain, these drugs cause impressive weight loss. Appetite decreases, satiety increases and the kilos seem to disappear,” explains the doctor.

And is it very expensive?

As for costs, even if the initial investment is high, in the long term, with weight reduction, it is reduced with drugs for diseases caused by obesity, according to the doctor.

“With this, we see the long-term economy. We can reduce medications against hypertension, cholesterol, antidepressants, among others,” explains the endocrinologist.

Deborah also points out that obesity medications are lifelong: “The rebound effect occurs because the disease is chronic. Of course, if you stop treatment, the weight will come back, since the disease is chronic and continues to evolve. Therefore, it is very important to understand that this is a lifelong treatment.”

The doctor underlines that for the first time there are effective treatments against obesity.

“Prevention efforts that address all factors that contribute to obesity must be strengthened, not abandoned, to ensure that the next generation does not require lifelong medications to maintain metabolic health. The patient’s lifestyle must also be modified, introducing good habits of sleep, physical activity and nutrition so that the results last”, says the doctor.

“We need to put a lot of emphasis on follow-up with doctors and not on self-medication, as that is the biggest danger. New analogues, Monjauro and Wegovy, even more powerful, will be launched in 2024 in Brazil and will be marketed in 2023 in Europe and the United States. These new drugs have the advantage of reducing visceral fat and therefore reducing the risk of heart attack and stroke, which are the main causes of death in those who are overweight and obese”, concludes the doctor.

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Source: Terra

Ben

Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.