Why hasn't science cured obesity?

New therapy for obesity

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In obese people, changing their diet and exercising to lose weight only help in the short term. Which, according to experts, has a better effect.

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Mainz - Diet changes and more exercise often have limited effects on people who are severely obese. The problem is not losing weight, but keeping the reduced weight. Doctors are increasingly advising patients who are very obese to have an operation with stomach reduction or gastric bypass. In addition, a new therapy with certain drugs that mimic the effects of intestinal hormones - people with pronounced obesity (adiposity) could help in the long term.

One in four suffers from obesity

The majority of adults in Germany are overweight with a body mass index (BMI) of over 25 - a quarter with a BMI of over 30 are even obese. Obesity is increasingly endangering the health of the population. "Obesity can lead to serious secondary diseases such as type 2 diabetes mellitus, fatty liver and high blood pressure," says Prof. Dr. Matthias M. Weber from the German Nutrition Society (DGE). Obese people are more likely to suffer from heart attacks, strokes, dementia, depression, joint diseases, obstructive sleep apnea, and some cancers. “They also die earlier. With a BMI of over 40, it's twelve years, ”says Weber, Head of Endocrinology and Diabetology at the Mainz University Medical Center.

Change of diet and exercise are not successful in the long term

Today we know that conservative obesity therapy is rarely successful in the long term. Prof. Dr. Matthias Blüher, head of the obesity outpatient clinic for adults at the Leipzig University Medical Center, explains: “There is no doubt that obesity is mainly caused by hypercaloric diet and lack of exercise.” But the concept of “eat less and move more” is usually not long-term crowned with success if you look at the effect of the therapy after a longer period of time. The patients who change their lifestyle lose about ten percent of their body weight in the first six months and then gain it again in the following six months. After a year, there is a permanent weight loss of two percent.

With drug therapy with tablets, in which the feeling of hunger is dampened or the absorption of food in the gastrointestinal tract is inhibited, things look a little better - but here too people lose weight and then gain weight again. After twelve months, they had only permanently reduced their weight by around eight percent. So the challenge is not only to lose weight, but also to keep the lower weight in the long term.

Gastric surgery can permanently reduce weight

"Only from bariatric surgery - that is, stomach reduction, gastric banding or gastric bypass - we currently know reliably that weight can be permanently reduced," says Blüher. According to the expert, long-term therapeutic success after obesity surgery also includes a multimodal therapy concept for optimal preparation and structured long-term follow-up care.

Incretin Analogs: Help from the Syringe

The obesity expert has high hopes for new drugs from the group of incretin analogues. Building on promising data, molecules are to be used in the future that combine the weight-reducing effects of glucagon-like peptide 1 (GLP-1) with those of glucagon and glucose-dependent insulinotropic polypeptides (GIP). The substances administered as a syringe imitate the effect of the intestinal hormone GLP-1. This stimulates the release of insulin, delays gastric emptying, leads to an earlier feeling of satiety and suppresses the appetite.

“Incretin analogues such as liraglutide are already being used successfully in people with type 2 diabetes mellitus. We already know the weight-reducing effect, ”explains Blüher. The experts also know from animal experiments that the effects of this therapy could be comparable to those of surgery. The obesity expert hopes that further funds will be added in the next few years: "The combined use could lead to a significantly greater weight reduction and then make an operation unnecessary in many cases."
  • Author: vitanet.de-np
  • Swell: Press release of the Association of Scientific Medical Societies in Germany: Obesity: Using syringes or a scalpel to tackle obesity