Tirzepatide Once Weekly for the Treatment of Obesity

New England Journal of Medicine, Journal Year: 2022, Volume and Issue: 387(3), P. 205 - 216

Published: June 4, 2022

Obesity is a chronic disease that results in substantial global morbidity and mortality. The efficacy safety of tirzepatide, novel glucose-dependent insulinotropic polypeptide glucagon-like peptide-1 receptor agonist, people with obesity are not known.

Language: Английский

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Adipose Tissue Dysfunction as Determinant of Obesity-Associated Metabolic Complications

International Journal of Molecular Sciences, Journal Year: 2019, Volume and Issue: 20(9), P. 2358 - 2358

Published: May 13, 2019

Obesity is a critical risk factor for the development of type 2 diabetes (T2D), and its prevalence rising worldwide. White adipose tissue (WAT) has crucial role in regulating systemic energy homeostasis. Adipose expands by combination an increase adipocyte size (hypertrophy) number (hyperplasia). The recruitment differentiation precursor cells subcutaneous (SAT), rather than merely inflating cells, would be protective from obesity-associated metabolic complications. In metabolically unhealthy obesity, storage capacity SAT, largest WAT depot, limited, further caloric overload leads to fat accumulation ectopic tissues (e.g., liver, skeletal muscle, heart) visceral depots, event commonly defined as "lipotoxicity." Excessive lipid local inflammation insulin resistance (IR). Indeed, overnutrition triggers uncontrolled inflammatory responses WAT, leading chronic low-grade inflammation, therefore fostering progression IR. This review summarizes current knowledge on dysfunction obesity associated abnormalities, such A better understanding mechanisms expansion required future therapeutic approaches

Language: Английский

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Chronic Adipose Tissue Inflammation Linking Obesity to Insulin Resistance and Type 2 Diabetes

Frontiers in Physiology, Journal Year: 2020, Volume and Issue: 10

Published: Jan. 29, 2020

Obesity is one of the major health burdens 21st century as it contributes to growing prevalence its related comorbidities, including insulin resistance and type 2 diabetes. Overwhelming evidence suggests a critical role for overnutrition in development low-grade inflammation. Specifically, chronic inflammation adipose tissue considered crucial risk factor diabetes obese individuals. The triggers are still poorly defined. However, obesity-induced expansion provides plethora intrinsic signals (e.g., adipocyte death, hypoxia, mechanical stress) capable initiating inflammatory response. Immune dysregulation subjects results characterized by increased infiltration activation innate adaptive immune cells. Macrophages most abundant cells infiltrating accumulating into individuals; they constitute up 40% all obesity. In obesity, macrophages polarized pro-inflammatory M1 secrete many cytokines impairing signaling; therefore, promoting progression resistance. Besides macrophages, other dendritic cells, mast neutrophils, B T cells) reside during playing key association inflammation, metabolic diseases makes pathways an appealing target treatment obesity-related complications. this review, we summarize molecular mechanisms responsible toward obesity-associated comorbidities highlight current therapeutic strategies.

Language: Английский

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The Science of Obesity Management: An Endocrine Society Scientific Statement

Endocrine Reviews, Journal Year: 2018, Volume and Issue: 39(2), P. 79 - 132

Published: March 6, 2018

The prevalence of obesity, measured by body mass index, has risen to unacceptable levels in both men and women the United States worldwide with resultant hazardous health implications. Genetic, environmental, behavioral factors influence development general public professionals stigmatize those who suffer from disease. Obesity is associated contributes a shortened life span, type 2 diabetes mellitus, cardiovascular disease, some cancers, kidney obstructive sleep apnea, gout, osteoarthritis, hepatobiliary among others. Weight loss reduces all these diseases dose-related manner—the more weight lost, better outcome. phenotype "medically healthy obesity" appears be transient state that progresses over time an unhealthy phenotype, especially children adolescents. best achieved reducing energy intake increasing expenditure. Programs are effective for include peer-reviewed approved lifestyle modification programs, diets, commercial weight-loss exercise medications, surgery. Over-the-counter herbal preparations patients use treat obesity have limited, if any, data documenting their efficacy or safety, there few regulatory requirements. regain expected patients, when treatment discontinued. When making decisions, clinicians should consider fat distribution individual risks addition index.

Language: Английский

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Obesity

Journal of the American College of Cardiology, Journal Year: 2018, Volume and Issue: 71(1), P. 69 - 84

Published: Jan. 1, 2018

Language: Английский

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Lifestyle modification approaches for the treatment of obesity in adults.

American Psychologist, Journal Year: 2020, Volume and Issue: 75(2), P. 235 - 251

Published: Feb. 1, 2020

The U.S. Preventive Services Task Force has recommended that primary care clinicians screen all adults for obesity and provide those affected intensive multicomponent behavioral interventions. Approximately 95 million qualify such care, also referred to as lifestyle modification. Using the Guidelines (2013) Managing Overweight Obesity in Adults (hereafter, Guidelines) a framework, this article reviews principal components of comprehensive modification, which include diet, physical activity, behavior therapy. To lose weight, recommend participation 6 months high-intensity programs 14 or more counseling sessions with trained interventionist. When provided face-to-face individual group treatment, participants up 8 kg (8% weight) experience improvements cardiovascular disease risk factors quality life. prevent weight regain, 1 year weight-loss-maintenance at least monthly counseling. High levels frequent monitoring body consumption reduced-calorie diet are associated long-term loss. Investigators currently seeking increase availability modification by delivering it community-based programs, well on digital platforms (e.g., Internet Smartphone). Digitally delivered lower costs expand treatment reach; their efficacy is likely improve further addition new technologies food intake, weight. Ultimately, management, must be joined collective institutional efforts nation's eating activity environments. (PsycINFO Database Record (c) 2020 APA, rights reserved).

Language: Английский

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Obesity as a Disease: The Obesity Society 2018 Position Statement

Obesity, Journal Year: 2018, Volume and Issue: 27(1), P. 7 - 9

Published: Dec. 20, 2018

The emerging obesity epidemic and accompanying health consequences led Obesity Society (TOS) in 2008 to publish a position paper defining as disease. Since then, new information has emerged on the underlying mechanisms leading excess adiposity associated structural, cardiometabolic, functional disturbances. This report presents updated TOS 2018 statement noncommunicable chronic

Language: Английский

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The Carbohydrate-Insulin Model of Obesity

JAMA Internal Medicine, Journal Year: 2018, Volume and Issue: 178(8), P. 1098 - 1098

Published: July 2, 2018

Despite intensive research, the causes of obesity epidemic remain incompletely understood and conventional calorie-restricted diets continue to lack long-term efficacy. According carbohydrate-insulin model (CIM) obesity, recent increases in consumption processed, high-glycemic-load carbohydrates produce hormonal changes that promote calorie deposition adipose tissue, exacerbate hunger, lower energy expenditure. Basic genetic research provides mechanistic evidence support CIM. In animals, dietary composition has been clearly demonstrated affect metabolism body composition, independently intake, consistent with CIM predictions. Meta-analyses behavioral trials report greater weight loss reduced-glycemic load vs low-fat diets, though these studies characteristically suffer from poor compliance. Feeding have lacked rigor duration test CIM, but longest such tend show metabolic advantages for low-glycemic diets. Beyond type amount carbohydrate consumed, a conceptual framework understanding how many nondietary exposures might alter hormones, metabolism, adipocyte biology ways could predispose obesity. Pending definitive studies, principles diet offer practical alternative focus on fat restriction.

Language: Английский

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Adiponectin-leptin ratio: A promising index to estimate adipose tissue dysfunction. Relation with obesity-associated cardiometabolic risk

Adipocyte, Journal Year: 2017, Volume and Issue: 7(1), P. 57 - 62

Published: Nov. 8, 2017

Obesity is currently the most extended metabolic disturbance worldwide favoring development of cardiometabolic alterations such as type 2 diabetes, hypertension, and dyslipidemia. syndrome (MS) are characterized by an increase in circulating leptin concentrations, parallel to a decrease blood levels adiponectin. Consequently, adiponectin/leptin ratio has been suggested maker adipose tissue dysfunction. This emerging biomarker correlates with insulin resistance better than adiponectin or alone, even HOMA decreased increasing number risk factors having proposed predictive marker for MS. Moreover, negatively correlated markers low-grade chronic inflammation. In this sense, related reduced atherosclerosis well some types cancer epidemiological studies. commentary we propose new cutoffs estimate obesity- MS-associated according discuss different therapeutic strategies promising risk.

Language: Английский

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Cardiovascular risk and obesity

Diabetology & Metabolic Syndrome, Journal Year: 2019, Volume and Issue: 11(1)

Published: Aug. 28, 2019

This is an overview of the mechanisms obesity and its relation to cardiovascular risks, describing available treatment options manage this condition. The pathogenesis includes balance between calories consumed energy expenditure followed by maintenance body weight. Diet, physical activity, environmental, behavioral physiological factors are part complex process weight loss, since there several hormones peptides involved in regulation appetite, eating behavior expenditure. complications associated also driven processes involving which include inflammation, insulin resistance, endothelial dysfunction, coronary calcification, activation coagulation, renin angiotensin or sympathetic nervous systems. Pharmacological treatments often needed insure loss as adjuncts diet activity people with overweight patients. To accomplish satisfactory goals, patients physicians seek for improvement risk condition, especially risk.

Language: Английский

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