Current and cutting-edge interventions for the treatment of obese patients

Abstract

The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current “gold standard” therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band. Though effective, bariatric surgery can have severe short- and long-term complications. To fill the major gap in invasiveness between lifestyle modification and surgery, researchers have been developing pharmacotherapies and minimally invasive endoscopic techniques to treat obesity. Recently, interventional radiologists developed a percutaneous transarterial catheter-directed therapy targeting the hormonal function of the stomach. This review describes the current standard obesity treatments (including diet, exercise, and surgery), as well as newer endoscopic bariatric procedures and pharmacotherapies to help patients lose weight. We present data from two ongoing human trials of a new interventional radiology procedure for weight loss, bariatric embolization.

Hibiscus and lemon verbena polyphenols modulate appetite-related biomarkers in overweight subjects: a randomized controlled trial

“…[2][3][4] Obesity is generally treated with a combination of approaches, including adopting a dietary intervention focused on calorie restriction, exercise and psychological support in order to achieve the real goals of weight reduction and efficient metabolic control of the pathology. 5,6 However, these strategies are difficult to implement in the overweight population in the long-term, where the patients tend to abandon treatment and regain the lost weight. As a result, obesity as well as the related noncommunicable diseases are common and often go unnoticed and untreated.…”

“…11 Such complexity is one of the reasons why many times it is necessary to include alternative approaches in the weight loss intervention, such as bariatric surgery, pharmacology, and nutritional intervention with dietary supplements or nutraceuticals. 6 All these approaches are part of the "Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-20" developed by the WHO to fight global obesity.…”

Perceived oral health in patients after bariatric surgery using oral health‐related quality of life measures

“…Obesity is an increasing problem of the 21st century and one of the fastest growing health problems worldwide (Buchwald & Williams, ; Flodgren, Goncalves‐Bradley, & Summerbell, ). Obesity may contribute to the occurrence of various health conditions such as diabetes mellitus, cardiovascular disease, stroke, hypertension, and certain cancer forms (Marsicano, Sales‐Peres, Ceneviva, & de Sales‐Peres, ; Vairavamurthy, Cheskin, Kraitchman, Arepally, & Weiss, ; Vinciguerra et al, ) and associates with oral health problems such as dental caries, periodontitis, and hyposalivation (Marsicano, Sales‐Peres, Ceneviva, & de Sales‐Peres, ). Bariatric surgery is considered to be one of the most effective and a safe method to achieve weight loss in adults and may improve systemic conditions (Barbosa et al, ; Costa, Yamaguchi, Santo, Riccioppo, & Pinto‐Junior, ).…”

Enhancing enterocyte fatty acid oxidation in mice affects glycemic control depending on dietary fat

“…With a rise in the consumption of western diets, and with decreasing physical activity, the incidence of obesity is increasing world over. Currently, the only treatments for morbid obesity that lead to sustained weight loss are invasive and costly interventions such as gastric bypass surgery 2 . The success of these surgical procedures comes with several unresolved side effects, including malabsorption of essential micronutrients and early or late post-surgical complications 2 .…”

“…Currently, the only treatments for morbid obesity that lead to sustained weight loss are invasive and costly interventions such as gastric bypass surgery 2 . The success of these surgical procedures comes with several unresolved side effects, including malabsorption of essential micronutrients and early or late post-surgical complications 2 . Interestingly, one of the consistent benefits of bariatric surgeries is improved glycemic control based on a reversal of insulin resistance (IR).…”