• Science Saturday: Researchers explore personalized approach to anti-obesity medications

Individualized medicine initiatives mainly focus on rare diseases or cancer. Little has been attempted to individualize treatment for noncommunicable chronic diseases such as obesity — a chronic, relapsing disease, and a primary cause of Type 2 diabetes, fatty liver disease, cardiovascular disease and cancer. There are many obesity interventions, such as diets, devices, surgery and medications. However, not much is known about the predictors of response to these obesity interventions.

"Sustained weight loss with current treatment options remains a challenge in the clinical practice," says Andres Acosta, M.D., Ph.D., a Mayo Clinic gastroenterologist and obesity expert.

To address this, Dr. Acosta and a team of Mayo Clinic researchers set out to study anti-obesity medications based on obesity phenotypes to enhance weight loss. A phenotype is a set of observable characteristics of a person resulting from the interaction of his or her genotype with the environment.

Their findings, published in the journal Obesity, show a phenotype-guided approach was associated with 1.75-fold greater weight loss after one year and the proportion of patients who lost more than 10% at one year was 79%, compared with 34% whose treatment was not phenotype-guided.

What are phenotypes, and why do they matter?

The team stratified obesity into four phenotypes:

  • Hungry brain ― mainly controlled by the brain-gut axis, and abnormal calories are needed to reach fullness.
  • Emotional hunger ― desire to eat to cope with positive or negative emotions.
  • Hungry gut ― abnormal duration of fullness.
  • Slow burn ― decreased metabolic rate.

With regard to energy balance ― intake versus expenditure ― these four phenotypes regulate body weight.

Read the rest of the article on the Center for Individualized Medicine blog.


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