Current innovative treatments of obesity
DOI:
https://doi.org/10.12775/JEHS.2023.21.01.020Keywords
obesity, diet, semaglutide, intermittent fastingAbstract
Obesity is a complex and pervasive chronic health concern with multifaceted origins in which abnormal or excessive fat accumulation worsens health, increases the risk of long-term medical complications and shortens life expectancy. It is associated with type 2 diabetes, non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease. More than 603.7 million adults are estimated to be obese. The cause of obesity is a long-term energy imbalance caused by a combination of increased energy intake and decreased energy expenditure.
The purpose of this study is to analyze the effectiveness of modern obesity treatments such as intermittent fasting, semaglutide and surgical interventions. Intermittent fasting involves voluntary periods of restricted or zero caloric intake at specified intervals. However, research results on the effectiveness of this dietary strategy are conflicting. The findings indicate that incorporating physical exercise can further enhance the outcomes of applying this diet. Semaglutide, a GLP-1 (glucagon-like peptide-1) analog, has shown efficacy in promoting weight loss among adults and adolescents, along with metabolic and cardiovascular improvements. Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure, while Roux-en-Y gastric bypass (LRYGB) is another option. Long-term studies show that both methods effectively promote weight loss.
In conclusion, obesity is a multifaceted condition that requires a comprehensive treatment approach. Individualized strategies including dietary changes, pharmaceutical interventions such as semaglutide, and surgical options can together contribute to effective weight management and improved health outcomes.
References
Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, Adamo K, Alberga A, Bell R, Boulé N, Boyling E, Brown J, Calam B, Clarke C, Crowshoe L, Di Valentino D, Forhan M, Freedhoff Y, Gagner M, Glazer S, Grand C, Green M, Hahn M, Hawa R, Henderson R, Hong D, Hung P, Janssen I, Jacklin K, Johnson-Stoklossa C, Kemp A, Kirk S, Kuk J, Langlois MF, Lear S, McInnes A, Macklin D, Naji L, Manjoo P, Morin MP, Nerenberg K, Patton I, Pedersen S, Pereira L, Piccinini-Vallis H, Poddar M, Poirier P, Prud'homme D, Salas XR, Rueda-Clausen C, Russell-Mayhew S, Shiau J, Sherifali D, Sievenpiper J, Sockalingam S, Taylor V, Toth E, Twells L, Tytus R, Walji S, Walker L, Wicklum S. Obesity in adults: a clinical practice guideline. CMAJ. 2020;192(31):E875-E891. doi: 10.1503/cmaj.191707
Cairns BJ, Huxley R, Jackson ChL, Joshy G, Lewington S, Manson JE, Murphy N, Patel AV, Samet JM, Woodward M, Zheng W, Zhou M, Bansal N, Barricarte A, Carter B, Cerhan JR, Smith GD, Fang X, Franco OH, Green J, Halsey J, Hildebrand JS, Jung KJ, Korda RJ, McLerran DF, Moore SC, O'Keeffe LM, Paige E, Ramond A, Reeves GK, Rolland B, Sacerdote C, Sattar N, Sofianopoulou E, Stevens J, Thun M, Ueshima H, Yang L, Yun YD, Willeit P, Banks E, Beral V, Chen Zh, Gapstur SM, Gunter MJ, Hartge P, Jee SH, Lam TH, Peto R, Potter JD, Willett WC, Thompson SG, Danesh J, Hu FB. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776-86. doi: 10.1016/S0140-6736(16)30175-1
Piché M, Chernoffa, Després JP. Obesity Phenotypes, Diabetes, and Cardiovascular Diseases. Circ Res. 2020;126(11):1477-1500. doi: 10.1161/CIRCRESAHA.120.316101
Afshin A, Forouzan Fahr MH, Reitsma MB, Sur P, Estep K, Lee A, Marczak L, Mokdad AH, Moradi-Lakeh M, Naghavi M, et al; GBD 2015 Obesity Collaborators. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377:13–27. doi: 10.1056/NEJMoa1614362
Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007-2008 to 2015-2016. JAMA. 2018;319:1723–1725. doi: 10.1001/jama.2018.3060
Abdullah A, Peeters A, de Courten M, Stoelwinder J. The magnitude of association between overweight and obesity and the risk of diabetes: a meta-analysis of prospective cohort studies. Diabetes Res Clin Pract. 2010;89(3):309-19. doi: 10.1016/j.diabres.2010.04.012
Aune D, Norat T, Vatten LJ. Body mass index, abdominal fatness and the risk of gallbladder disease. Eur J Epidemiol. 2015;30(9):1009-19. doi: 10.1007/s10654-015-0081-y
Grover SA, Kaouache M, Rempel P, Joseph L, Dawes M, Lau DC, Lowensteyn I. Years of life lost and healthy life-years lost from diabetes and cardiovascular disease in overweight and obese people: a modeling study. Lancet Diabetes Endocrinol. 2015;3(2):114-22. doi: 10.1016/S2213-8587(14)70229-3
Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist. 2010;15(6):556-65. doi: 10.1634/theoncologist.2009-0285
Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB. Years of life lost due to obesity. JAMA. 2003;289(2):187-93. doi: 10.1001/jama.289.2.187
Ackerman SE, Blackburn OA, Marchildon F, Cohen P. Insights into the Link Between Obesity and Cancer. Curr Obes Rep. 2017;6(2):195-203. doi: 10.1007/s13679-017-0263-x
World Health Organization . Obesity: Preventing and Managing the Global Epidemic: Report of a WHO Consultation. WHO Technical Report Series 894. World Health Organization; Geneva, Switzerland: 2000
Blüher M. Obesity: Global epidemiology and pathogenesis. Nat. Rev. Endocrinol. 2019;15:288–298. doi: 10.1038/s41574-019-0176-8
Hill J.O., Wyatt H.R., Peters J.C. Energy balance and obesity. Circulation. 2012;126:126–132. doi: 10.1161/CIRCULATIONAHA.111.087213
Camacho S., Ruppel A. Is the calorie concept a real solution to the obesity epidemic? Glob. Health Action. 2017;10:1289650. doi: 10.1080/16549716.2017.1289650
Wright J.D., Kennedy-Stephenson J., Wang C.Y., McDowell M.A., Johnson C.L. Trends in Intake of Energy and Macronutrients—United States, 1971–2000. JAMA. 2004;53:80–82. doi: 10.1001/jama.291.10.1193
Williams EP, Mesidor M, Winters K, Dubbert PM, Wyatt SB. Overweight and Obesity: Prevalence, Consequences, and Causes of a Growing Public Health Problem. Curr Obes Rep. 2015;4(3):363-70. doi: 10.1007/s13679-015-0169-4
Shaharir SS, Gafor AH, Said MS, Kong NC. Steroid-induced diabetes mellitus in systemic lupus erythematosus patients: analysis from a Malaysian multi-ethnic lupus cohort. Int J Rheum Dis. 2015;18(5):541-7. doi: 10.1111/1756-185X.12474
Zhang X, Zhang M, Zhao Z, Huang Z, Deng Q, Li Y, Pan A, Chun L, Chen Z, Zhou M, Yu C, Stein A, Jia P, Wang L. Obesogenic environmental factors of adult obesity in China: a nationally representative cross-sectional study. Environmental Research Letters. 2020;15(4): 044009. doi: 10.1088/1748-9326/ab6614
Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014;63(14):1345-54. doi: 10.1016/j.jacc.2014.01.022
Vasim I, Majeed CN, DeBoer MD. Intermittent Fasting and Metabolic Health. Nutrients. 2022;14(3):631. doi: 10.3390/nu14030631
Malinowski B., Zalewska K., Węsierska A., Sokołowska M.M., Socha M., Liczner G., Pawlak-Osińska K., Wiciński M. Intermittent Fasting in Cardiovascular Disorders-An Overview. Nutrients. 2019;11:673. doi: 10.3390/nu11030673
Wiechert M, Holzapfel C. Nutrition Concepts for the Treatment of Obesity in Adults. Nutrients. 2021;14(1):169. doi: 10.3390/nu14010169
Conley M., Le Fevre L., Haywood C., Proietto J. Is two days of intermittent energy restriction per week a feasible weight loss approach in obese males? A randomized pilot study. Nutr. Diet. 2018;75:65–72. doi: 10.1111/1747-0080.12372
Kunduraci YE, Ozbek H. Does the Energy Restriction Intermittent Fasting Diet Alleviate Metabolic Syndrome Biomarkers? A Randomized Controlled Trial. Nutrients. 2020;12(10):3213. doi: 10.3390/nu12103213
Cioffi I., Evangelista A., Ponzo V., Ciccone G., Soldati L., Santarpia L., Contaldo F., Pasanisi F., Ghigo E., Bo S. Intermittent versus continuous energy restriction on weight loss and cardiometabolic outcomes: A systematic review and meta-analysis of randomized controlled trials. J. Transl. Med. 2018;16:371. doi: 10.1186/s12967-018-1748-4
Harvie M.N., Pegington M., Mattson M.P., Frystyk J., Dillon B., Evans G., Cuzick J., Jebb S.A., Martin B., Cutler R.G., et al. The effects of intermittent or continuous energy restriction on weight loss and metabolic disease risk markers: A randomized trial in young overweight women. Int. J. Obes. 2011;35:714–727. doi: 10.1038/ijo.2010.171
Sundfør T.M., Svendsen M., Tonstad S. Effect of intermittent versus continuous energy restriction on weight loss, maintenance and cardiometabolic risk: A randomized 1-year trial. Nutr. Metab. Cardiovasc. Dis. 2018;28:698–706. doi: 10.1016/j.numecd.2018.03.009
Harris L., Hamilton S., Azevedo L.B., Olajide J., de Brún C., Waller G., Whittaker V., Sharp T., Lean M., Hankey C., et al. Intermittent fasting interventions for treatment of overweight and obesity in adults: A systematic review and meta-analysis. JBI Database System. Rev. Implement. Rep. 2018;16:507–547. doi: 10.11124/JBISRIR-2016-003248
Allaf M., Elghazaly H., Mohamed O.G., Fareen M.F.K., Zaman S., Salmasi A.-M., Tsilidis K., Dehghan A. Intermittent fasting for the prevention of cardiovascular disease. Cochrane Database Syst. Rev. 2021;1:CD013496. doi: 10.1002/14651858.CD013496
Templeman I., Smith H.A., Chowdhury E., Chen Y.-C., Carroll H., Johnson-Bonson D., Hengist A., Smith R., Creighton J., Clayton D., et al. A randomized controlled trial to isolate the effects of fasting and energy restriction on weight loss and metabolic health in lean adults. Sci. Translate. Med. 2021;13:eabd8034. doi: 10.1126/scitranslmed.abd8034
Lowe D.A., Wu N., Rhodin-Bibby L., Moore A.H., Kelly N., Liu Y.E., Philip E., Vittinghoff E., Heymsfield S.B., Olgin J.E., et al. Effects of Time-Restricted Eating on Weight Loss and Other Metabolic Parameters in Women and Men With Overweight and Obesity: The TREAT Randomized Clinical Trial. JAMA Intern. Med. 2020;180:1491–1499. doi: 10.1001/jamainternmed.2020.4153
Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingway I, McGowan BM, Rosenstock J, Tran MTD, Wadden TA, Wharton S, Yokote K, Zeuthen N, Kushner RF; STEP 1 Study Group. Once-Weekly Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2021;384(11):989-1002. doi: 10.1056/NEJMoa2032183
Weghuber D, Barrett T, Barrientos-Pérez M, Gies I, Hesse D, Jeppesen OK, Kelly AS, Mastrandrea LD, Sørrig R, Arslanian S; STEP TEENS Investigators. Once-Weekly Semaglutide in Adolescents with Obesity. N Engl J Med. 2022;387(24):2245-2257. doi: 10.1056/NEJMoa2208601
Marso SP, Bain SC, Consoli A, Elishewitz FG, Jódar E, Leiter LA, Lingvay I, Rosenstock J, Seufert J, Warren ML, Woo V, Hansen O, Holst AG, Pettersson J, Vilsbøll T; SUSTAIN-6 Investigators. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834-1844. doi: 10.1056/NEJMoa1607141
Salminen P, Grönroos S, Helmiö M, Hurme S, Juuti A, Juusela R, Peromaa-Haavisto P, Leivonen M, Nuutila P, Ovaska J. Effect of Laparoscopic Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass on Weight Loss, Comorbidities, and Reflux at 10 Years in Adult Patients With Obesity: The SLEEVEPASS Randomized Clinical Trial. JAMA Surg. 2022;157(8):656-666. doi: 10.1001/jamasurg.2022.2229
Kotarsky CJ, Johnson NR, Mahoney SJ, Mitchell SL, Schimek RL, Stastny SN, Hackney KJ. Time-restricted eating and concurrent exercise training reduces fat mass and increases lean mass in overweight and obese adults. Physiol Rep. 20219(10):e14868. doi: 10.14814/phy2.14868
Angelidi AM, Kokkinos A, Sanoudou D, Connelly MA, Alexandrou A, Mingrone G, Mantzoros CS. Early metabolomic, lipid and lipoprotein changes in response to medical and surgical therapeutic approaches to obesity. Metabolism. 2023;138:155346. doi: 10.1016/j.metabol.2022.155346
Rubino DM, Greenway FL, Khalid U, O'Neil PM, Rosenstock J, Sørrig R, Wadden TA, Wizert A, Garvey WT; STEP 8 Investigators. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial. JAMA. 2022;327(2):138-150. doi: 10.1001/jama.2021.23619
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