Trends in Obesity Treatment Options

Single-receptor glucagon-like peptide-1 (GLP-1) agonists were originally developed as treatments for type 2 diabetes and have recently surged in global popularity due to their ability to improve metabolic health and pharmacologically treat obesity. A new review led by Christine M Kusminski at The University of Texas Southwestern Medical School details the development of multi-receptor agonists developed for obesity therapy that target combinations of GLP-1, glucose-dependent insulinotropic polypeptide (GIP), and glucagon receptors. Transforming obesity: The advancement of multi-receptor drugs. https://lnkd.in/exm_k737 The authors described the rationale for combining GLP-1 and glucagon receptor activation, detailing the development of several key GLP-1R/GCGR co-agonists. They then extensively discussed GLP-1R/GIPR co-agonists, with a primary focus on tirzepatide. They present comprehensive clinical data from the SURPASS and SURMOUNT trial programs, showcasing tirzepatide's superior efficacy in both glycemic control and weight loss. The review also includes  in a discussion of triagonist peptides targeting GLP-1, GIP, and glucagon receptors simultaneously. The authors presented both preclinical and early clinical data on these compounds, with a particular focus on retatrutide. They highlighted the unprecedented weight loss achieved with these agents, noting that they approach the efficacy of bariatric surgery. The authors also addressed potential limitations and side effects of these therapies. They discussed the phenomenon of weight regain upon treatment discontinuation, concerns about loss of lean mass, and the challenges of using these therapies in specific populations. The review also touched on the current supply limitations and high costs of these novel therapies. In their conclusion, the authors reflected on the remarkable progress made in obesity pharmacotherapy. They positioned these advancements as a potential turning point in obesity treatment, while also emphasizing the need for long-term safety data and equitable access to these transformative therapies. The authors highlighted ongoing challenges and areas for future research, including the need to better understand the precise mechanisms of action for each receptor component in multi-agonist therapies.

**MORE THAN JUST A SHOT: HOLISTIC MANAGEMENT OF OBESITY** GLP-1 / GIP agonists medications are powerful tools in obesity management, offering substantial weight reduction (8-21% in trials). Weight reduction results in decreased neuroinflammation, which likely translates into improved outcomes of psychiatric co-morbidities. Yet, as I have observed in my patients, real-world outcomes of using these weekly injectables reveal challenges: from gastrointestinal side effects and nutritional deficiencies to muscle and bone loss, adherence issues, and high treatment costs. Crucially, these medications are most effective when paired with comprehensive, evidence-based nutritional and lifestyle interventions! Current practice guidelines emphasize integrating: - Personalized initiation discussions and goal setting. - Baseline screening for dietary patterns, emotional eating, medical conditions, and disordered eating. - Comprehensive physical assessments including muscle strength and body composition. -Social determinants of health evaluations. Lifestyle assessments covering activity levels, mental stress, sleep, and social connections. - Ongoing nutritional and medical management is essential to handle side effects, altered dietary preferences, and prevent nutrient deficiencies, along with preserving muscle and bone mass through resistance training and protein-rich diets. - Supportive strategies, such as group-based visits, nutritional counseling, telehealth, and Food is Medicine initiatives, significantly enhance outcomes and equity. Holistic care isn't merely additive, it's foundational. Leveraging comprehensive approaches empowers clinicians to enhance both patient health and treatment effectiveness. Reference: Check out this hot off the press journal article for more in depth information: https://lnkd.in/eMv83B4x #ObesityTreatment #WholePatientCare #GLP1Agonists #Nutrition #LifestyleMedicine #PatientCenteredCare #psychiatry #psychotherapy

𝐈𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐔𝐩𝐝𝐚𝐭𝐞 𝐨𝐧 𝐎𝐛𝐞𝐬𝐢𝐭𝐲 𝐓𝐫𝐞𝐧𝐝𝐬 𝐢𝐧 𝐭𝐡𝐞 𝐔𝐧𝐢𝐭𝐞𝐝 𝐒𝐭𝐚𝐭𝐞𝐬: GLP‑1 receptor agonists — including Ozempic, Wegovy, Mounjaro, and Zepbound — have had a transformative impact on obesity management in the United States. Following a threefold increase in adult obesity rates from 1960 to 2021, recent U.S. health data now shows a modest but significant 2% decline from 2022 to 2025, a shift widely attributed to the rising use of GLP‑1 medications. The adoption of GLP‑1 drugs has accelerated rapidly. Between 2019 and 2024, prescriptions increased by nearly 587%, rising from 0.3% to 2.05% of overweight or obese adults. Usage has climbed particularly among women approaching menopause, with 18.6% of women on GLP‑1s using them for weight loss compared to 9.3% of men. Adherence rates are also improving. Nearly 63% of patients who began treatment with Wegovy or Zepbound in early 2024 remained on therapy after one year — a significant increase from 40% in 2023. Clinical trials report average weight reductions of 15–21% with semaglutide or tirzepatide over 12 months, outcomes comparable to some bariatric procedures. As a result, the volume of bariatric surgeries has declined, reflecting a shift toward medical rather than surgical obesity interventions. However, this may prove to be a temporary trend, depending on long-term efficacy, cost, and clinical practice guidelines for GLP‑1 use. Beyond weight loss, GLP‑1 therapies offer broader health benefits. These agents improve metabolic function, reduce systemic inflammation, and lower cardiovascular risk. Notably, the SELECT trial found a 19% reduction in all-cause mortality and a 20% reduction in cardiovascular deaths among patients treated with semaglutide. Despite these advances, significant barriers remain. Fewer than 3–4% of eligible obese adults currently receive GLP‑1 prescriptions, due to disparities in insurance coverage, cost, and geographic access. Out-of-pocket costs often exceed $1,000 per month, prompting some individuals to seek unregulated sources, which pose safety risks. Side effects are also a consideration. Common adverse effects include nausea, vomiting, and gastrointestinal discomfort. Long-term safety is still under review, particularly regarding risks of medullary thyroid cancer, gallbladder disease, and diabetic retinopathy. For this reason, baseline screening and ongoing monitoring are essential, especially in patients with diabetes or pre-existing thyroid conditions. GLP‑1 receptor agonists represent the first pharmacologic intervention with the potential to reverse national obesity trends. While challenges in access, cost, and long-term safety remain, these medications are already reshaping the landscape of obesity treatment in the United States — with implications for individual health and public policy for years to come. #obesitytrends #glp #hearthealth