Over 4 Million Deaths per Year Caused by Obesity: Safe, Non-Invasive Treatments Could Help End Epidemic

Novel obesity treatments such as modulation of the gut microbiome and gene therapy are underutilized and could help fight the obesity epidemic, according to a new manuscript published in the Endocrine Society’s journal, Endocrine Reviews.

Nearly half of the adults and 20 percent of children in the United States have obesity, yet doctors are under prescribing effective weight loss medications and many patients are not receiving the treatment they need. The weight stigma that exists in healthcare settings makes people with obesity hesitant to seek care until comorbidities develop and reach a dangerous stage. Lack of insurance coverage and cost issues are another factor that creates barriers to obesity treatment.

“Obesity is the epidemic crisis of our time. The disease leads to serious comorbidities such as diabetes, fatty liver disease and cardiovascular disease and significantly shortens a person’s length and quality of life,” said Christos S. Mantzoros, M.D., Sc.D., of Beth Israel Deaconess Medical Center in Boston, Mass. “Until recently we did not understand the genetic and hormonal causes of obesity and how obesity leads to these comorbidities. We have recently started to understand the causes of obesity in humans, which is a big discovery that has led to designing effective therapies.”

In the article, the researchers map out the molecular and hormonal pathways that lead to obesity and the disease’s related comorbidities. This data gives researchers the insights they need to design, test and implement new obesity therapies.

The researchers highlight the need for safer and more effective obesity therapies, including new drug delivery systems, vaccines, modulation of the gut microbiome and gene therapy. Novel medications, including combinations of gastrointestinal hormones and other molecules, are being tested and are expected to lead to significant percentages of weight loss with less side effects once available. As our understanding of obesity improves, more effective medications with fewer side effects will be developed.

Recently approved medications such as semaglutide, a modified gastrointestinal hormone administered once a week, can lead to 15% weight loss when combined with lifestyle changes. Bariatric surgery can lead to up to 40% weight loss, but it is invasive and linked to complications.

“Insurance companies need to pay attention to data from studies and the scientific progress we are making and start covering the medications that are and will be approved soon, given that currently only a small minority of patients with obesity have coverage for the medications and medical care they need,” Mantzoros said. “It would be much more cost effective to cover treatments early instead of waiting for comorbidities and their complications to develop.”

Other authors of the study include: Angeliki Angelidi and Matthew Belanger of Harvard Medical School in Boston, Mass., and Alexander Kokkinos and Chrysi Koliaki of Laiko General Hospital in Athens, Greece. The research received no external funding.

Reference: “Novel Non-invasive Approaches to the Treatment of Obesity: From Pharmacotherapy to Gene Therapy” by Angeliki M Angelidi, Matthew J Belanger, Alexander Kokkinos, Chrysi C Koliaki and Christos S Mantzoros, 26 October 2021, Endocrine Reviews.
DOI: 10.1210/endrev/bnab034

DeathsEndocrineEndocrine SocietyGene TherapyObesityPharmaceuticalsPopularWeight Loss
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  • Greg Sykes

    This article is so disappointing. Obesity is not a disease to be treated; it’s not caused by a germ or something external to myself. If I want to stop being fat (which I do) then I can change my lifestyle (which I am) so that I move my body more and eat fewer calories than I utilize each day; this is simple math. Good, old-fashioned hard work and effort aren’t a treatment. Rather, they are what I should already be doing but haven’t. The responsibility and accountability for what I eat and what I do rests on my shoulders. Tricking someone into paying a pharmaceutical company to make them “not fat” is P. T. Barnum’s dream, and I’m not a fool.

  • Rhonda K

    Obesity IS a disease and so much more complicated than calories in vs. calories out. If it were as simple as willpower it would not be an epic problem. Seeing it as a moral issue is part of the problem the stigma remains. Obesity is a biopsychisocial disease just like any other chronic illness that requires chronic disease management and patients deserve access to quality care at reasonable expense, which doesn’t happen. No one is saying lifestyle change shouldn’t be a part of the treatment, but medication therapy that works is also needed for some. Treatment plans should be tailored to each individual as needed. It’s way overdue!

    • K.K

      Thank you…

    • William Readling

      Obesity is a disease, the way heroin addiction, or alcoholism is. The biggest difference is that you must eat to live, and moderation is difficult.

  • P

    Why do the opening silhouettes show a woman and not a man? Isn’t obesity a problem of both sexes? Why is it always assumed that only women care about weight?

  • Kay

    Good for you, Greg! Check back with us in 5 years, and let us know how successful you have been! And maybe do a little research into how successful behavior modification is for weight loss, because it is incredibly poor as a treatment. Simple math huh? Everyone has known people who could eat an incredibly high amount of food and burn it all off. So why don’t people want to believe that some bodies are just very efficient at STORING and conserving energy? And PT Barnum is dead.

  • CoCo

    It depends on why one is overweight. Sometimes it is internal, a metabolic issue. Hormones, GMOs, medications, mental illness, all play a role.

  • Rachael

    Read the book The Metabolic Storm by Dr. Emily Cooper. There are a whole host of issues that lead to obesity that have nothing to do with calories in/calories out. Indeed, that misperception is a driving force of fatphobia.

  • Naima

    Sykes isn’t wrong but clearly most obese people are not for one reason or another, possibly poor mental health, doing those things that he says he is doing to eradicate obesity. Like it or not it is a precondition for devastating illness and avoidable deaths. If it is preventable by any means necessary then do it. Because it is necessary. Society does not benefit from widespread morbidities.

  • Mary L.

    Speaking from over 55 years of experience. I can say , intake /outtake of food does not matter . Being really physical 18 hours a day , did not matter . When I was 7 , 8 , 9 ,10 and onward . Doctors were asked by my Mother and myself . Why am I gaining weight and not losing it. DOCTOR says ” your eating to much and don’t move enough ” . HAH ! I hated food , sometimes I still hate eating.
    I have an average intake of 500 calories a day . On occasion I do eat 1200 , which I consider extreme eating. With some people it may be the amount they eat . I figured it was true , all I have to do is think about eating or walk past a calorie and I gain . It is hard to Have to eat when you have learned to hate food . My doctor now , knows with my bloodwork, that ( her words) I am healthier than herself and her 2 young aids . My weight gain started in the mid 60s when I started school . Eating cafeteria food . Was there chemicals in it that affected me ? I have no idea . Now Having Lyme and babesisa makes it even harder . I rarely get hungry . Usually manage 1 meal a day . Consisting of 1 thing. Like potatoes. Baked or mashed. Ramone noodles , without flavor packet . I do lose weight if I eat sweets . But I can’t do that very long . Someday , hopefully before I am 90 , a reason will be discovered. Some day maybe I won’t be hearing horrible insults about my size . Maybe someday a large person’s size won’t be blamed on the amount of food consumed. I can only speak for myself and what I have experienced. Telling a big person like me to cut back eating , to take appetite suppressants, to get that surgery. It sounds ludicrous. I already don’t get hungry . To cut back would mean to eliminate all intake of food . Believe it or not , 500 calories is not much . Since I weigh more , I exzert energy and burn more . Anyway . One day , a truly stupendous medical person will discover what is happened and happening to me . And a lot of others . It is more than , fat equals over eating . It is more than , she/he is lazy . Teenagers could not keep up with me at my physical job . Same age people could not either. I know one thing . God gave me a life , where I enjoyed working, I enjoyed shocking people with my agility and abilities. I like that my doctor is dumbfounded that my bloodwork is ideal for someone smaller and decades younger . Now to get rid of the Lyme disease and babesisa and try to get my strength back . Every day I thank God for my life . And I still ask , why do some adults have to be so mean . We all answer for what we do . I Pray for all who go through what I do . I know , one day someone will figure out why my body refuses to let go of the unwanted, un-needed extra weight . Until then , I prefer to stay away from people and try to get rid of this chronic ( 15 years undiagnosed) lyme and babesisa. 4 years on and off antibiotics. Battle 1 thing at a time . God Bless and stay good ..