GUaire from obesity is a tortuous and complex path, until now difficult to manage, often with a high failure rate in the initial therapies. But today, thanks to the New generation drugsthere is a paradigm change. It is no longer just about losing weight, but of offer customized solutions that take into account the metabolic profile and the cardiovascular risk of each patient.
What is obesity?
Obesity is a chronic condition characterized by an excess of body fat, which can compromise health. According to the World Health Organization (WHO), we speak of obesity when the BMI (body mass index) It exceeds 30 kg/m². It is important distinguish overweight (BMI between 25 and 29.9) from obesity real, which represents a higher risk for cardiovascular diseases, type 2 diabetes, night apnea and some tumors.
Obesity: who strikes more?
Second The Italian Obesity Barometer Report 2023, in Italy the 46% of the adult population is overweightwhile the 12% is obese. Obesity affects people with more frequently with low socio -economic levelthe Women in post-Menopauseand children in families at risk Education povertyto.
Source: Higher Institute of Health.
The new drugs: an epochal turning point in the treatment of obesity
In addition to diet and physical activity, they established themselves New pharmacological therapies. Among these, semaglutide (commercial name Wegovy or Ozempic) And tirzepatide (Mounjaro) showed significant efficacy in weight reduction, acting as GLP-1 receptor agonists. A study published on The New England Journal of Medicine (Wilding et al., 2021) has shown that the traffic lights can reduce body weight by 15% on average in subjects with obesity.
Study source: https://www.nejm.org/doi/full/10.1056/nejmoa2032183.
A more personalized approach
From the traffic lightseven in the pill, cure -all for the heart in particular In diabetic patients with obesityat the tirzepatide, new molecule that It acts on two intestinal hormones With a weight loss of over 20%, the new drugs inaugurated an epochal turning point in the treatment of obesity. Thanks to these, in clinical practice we resort less and less to the process based on attempts and errors, very frustrating for patients. Over 50% manage to obtain a significant weight loss on the first shot. While with previous therapies, the initial success rate was just 30%. Now the new challenge is a more personalized approach to the treatment of obesity which is no longer a condition without options. To take stock of the current events and prospects of the therapeutic panorama, are the maximum experts gathered in Turin for the congress of the Italian Society of Endocrinology (SIE).
1 adult out of 2 is overweight
“In our country, according to the data of the Higher Institute of Health, 1 adult out of 2 is overweight, about 23 million people, while 6 million, almost 12% of the population, suffers from obesity. A complex condition, for too long considered difficult to manage, often, in the past, with a rate of over 70% of bankruptcy in the initial therapies – declares Gianluca Aimetti, President of the Italian Society of Endocrinology (SIE) and Director of the Department of Translational Medicine (Dimet) of the University of Eastern Piedmont ” -.
A therapeutic revolution
«Today, thanks to new generation drugs, we are witnessing a real therapeutic revolution which, in addition to offering concrete hope to millions of people, also promises to radically transform the management of metabolic and cardiovascular health. It is no longer just a matter of losing weightbut to offer Personalized solutions who take into account the metabolic profile and the heart risk of each patient -he underlines -.
However, despite the recent progress have led to the results never seen, precisely in terms of weight, improving comorbilities, and even reducing cardiovascular mortalitythere is still an individual variability in terms of response to antiobesity drugs. Even with the most effective ones there is no ‘universal’ and attempting solution and errors for the selection of therapies still involve an increase in costs and the risk of side effects -he adds -. The development of a precision medicine approach is therefore necessary to optimize the results in terms of weight loss and identify patients who better respond to a specific intervention “.
Obesity therapy can and must be customized
The traffic lights, already a point of reference in the treatment of obesity, has shown that it is Much more than a simple weight loss drug. The Studio Scorea large analysis on real-world data conducted on thousands of patients with type 2 diabetes, revealed a stunning data: the use of traffic lights is associated with a 57% reduction in the risk of heart attack and stroke compared to untreated. “This result further strengthens what has already emerged from the Select Studio, which first had highlighted the cardiovascular benefit of the traffic light in people with obesity without diabetes -underlines Aimetti -“.
Semaglutide also in the pill
But the news does not end there. «The Soul Studio has explored the effectiveness of the traffic lights, also in the pill, in patients with type 2 diabetes and high cardiovascular risk, demonstrating a 14% reduction in cardiovascular events. This means that the drug is also effective in an alternative formulation, eliminating the need for injections and making the treatment more accessible for many ».
Exceptional results
On the weight loss front, the Step-up study evaluated a higher experimental dose of traffic lights (7.2 mg/week), with exceptional results: the treated patients lost more than 20% of body weight on average, and 1 in 3 exceeded 25% of weight loss.
The tirzepatide
At the same time, attention has also grown around the tirzepatide, an innovative molecule that It acts on two intestinal hormones (Gip and GLP-1). In the recent Surmount-5 study, Tirzepatide has shown one weight loss higher than that obtained with the traffic light 2.4 mg, with the same tolerability. Although the official cardiovascular data (surpass-cvot) are not yet available, expectations are high, with the provision of a similar protective effect.
“It’s the beginning of one New phase of obesity medicinefinally closer to the real needs of patients. This new era marks a fundamental step towards one better quality of life for millions of individuals, offering not only an effective way to weight loss, but also one robust protection against cardiovascular diseases»Concludes Aimetti.
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