Five Anti-Obesity Medications Evaluated for Cost-Effectiveness

A primary consideration that this analysis could not investigate is the issue of long-term weight loss. Interview with:

Ainhoa Gomez-Lumbreras, MD, PhD
Post-Doctoral Fellow
Department of Pharmacotherapy
College of Pharmacy, University of Utah

Dan Malone, PhD
Department of Pharmacotherapy
College of Pharmacy, University of Utah
Salt Lake City, UT 84112  What is the background for this study? 

Response: Obesity, defined as having a body mass index of 30 or more, is a multifactorial disease that has been associated with cardiovascular and respiratory diseases, diabetes, and others. By 2030 it is expected that half of the U.S. adult population will be obese. More pharmacologic products are being investigated for weight loss, including the new anti-diabetes medications liraglutide, semaglutide and tirzepatide.

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Gender Differences in Core Body Temperature Interview with:
Reed Thomas BS and
Dr. Kong Y. Chen PhD
Director, Human Energy & Body Weight Regulation Core
NIH  What is the background for this study? 

Response: Over the last century, many studies have looked at the thermoregulation of both arctic and tropical animals; however, far fewer have rigorously measured variations in human thermal physiology, and even less have compared women and men. This study is a part of our ongoing efforts to fill that gap.

Variety of Healthy Dietary Patterns can be Recommended to Reduce Risk of Chronic Diseases and Premature Death

These patterns such as the Mediterranean diet, DASH diet, vegetarian diet, or other versions of healthy diets can be adapted to meet individual health needs, food preferences, and cultural traditions. Interview with:
Frank B. Hu, MD, PhD
Professor and Chair
Department of Nutrition
Harvard T.H. Chan School of Public Health

Dr. Frank Hu  What is the background for this study? What are the main findings?

Response: The current Dietary Guidelines for Americans (DGAs) recommend multiple healthy eating patterns. However, few studies have evaluated whether greater adherence to the DGAs-recommended dietary patterns is associated with long-term risk of total and cause-specific mortality. The researchers used health data collected over 36 years from 75,230 women participating in the Nurses’ Health Study and 44,085 men in the Health Professionals Follow-up Study. All participants were free of cardiovascular disease or cancer at the beginning of the study and completed dietary questionnaires every four years.

Their information was scored based on each of the four dietary pattern indexes (Healthy Eating Index 2015, Alternate Mediterranean Diet, Healthful Plant-based Diet Index, and Alternate Healthy Eating Index). All share key components including whole grains, fruits, vegetables, nuts, and legumes, although other components differ across different eating patterns. 

Small Weight Loss in Older Men Might Signify Increased Risk of Mortality

Older individuals with a weight loss of 5-10% had a higher risk of all-cause mortality: 33% for men and 26% for women. Interview with:
Dr Monira Hussain MBBS, MPH, PhD
Senior Research Fellow & 
ECF Clinical Research Australian Fellow 
Public Health and Preventive Medicine
Monash University
Melbourne Australia

Dr Monira Hussain MBBS, MPH, PhD
Senior Research Fellow & 
ECF Clinical Research Australian Fellow 
Public Health and Preventive Medicine
Monash University
Melbourne Australia  What is the background for this study? 

Response: The impact of weight changes on healthy older adults is not fully understood, and the association between weight loss and cause-specific mortality needs to be explored using more reliable methods.

Hopkins Study finds Weight Loss by Bariatric Embolization Principally from Fatty Tissues

The data from this preliminary study represents a healthy pattern of weight loss in support of bariatric embolization as a valid therapeutic for obesity. Interview with:

Daniel Giraldo-Herrera, MD,
Postdoctoral research fellow
Johns Hopkins University School of Medicine and
Clifford R. Weiss, MD, PI of the study
Professor of Radiology and Biomedical Engineering
Johns Hopkins University School of Medicine, and
Whiting School of Engineering.  What is the background for this study? Would you describe the procedure and how it works to reduce obesity?

Response: Bariatric Embolization is a minimally invasive image-guided medical procedure for patients with morbid obesity who seek weight loss. The procedure is performed with tiny catheters through small nicks in the skin, deploying precisely engineered microscopic beads. These are deposited to block blood flow in the upper part of the stomach to reduce appetite by suppressing the release of the hunger-stimulating hormone ghrelin. With less hunger, patients can then more easily restrict excess calories from food intake. Weight loss results as they tap their own caloric energy reserves, ideally from subcutaneous fat (the deposits between the skin and deep muscle tissues) and visceral fat (the deposits surrounding abdominal organs). Protein stored in muscle can also be turned to calories for energy.

The purpose of this study was to understand if weight loss resulting from Bariatric Embolization comes from fat, muscle, or a mix of both. In a pilot trial, we used AMRA Medical’s advanced body composition measurement techniques with magnetic resonance imaging (MRI) to determine body composition changes in the abdomen and thighs, where the most significant fat deposits and muscle groups are located. MRI is the reference standard for body composition measurement since it allows for rapid, detailed analysis of anatomic distributions and accurate measurement of fat and muscle tissue volumes.

Intermittent Fasting Plus Exercise Can Reduce Help Decrease Liver Fat

Fatty liver disease puts people at high risk of developing type 2 diabetes. Interview with:
Krista Varady, PhD
Professor of Nutrition
Dept Kinesiology and Nutrition
University of Illinois Chicago
Chicago, Illinois, 60612
Instagram: @DrKristaVarady  What is the background for this study? 

Response: We noticed that the main lifestyle therapy for non-alcoholic fatty liver disease (NAFLD) was combining daily calorie restriction with aerobic exercise. We were curious if intermittent fasting combined with aerobic exercise would produce the same reductions in liver fat.

So we designed a randomized controlled trial in 80 adults with obesity and NAFLD, with four intervention groups:

1) An alternate day fasting group that consumed 500 calories on the “fast day”, alternated with a free eating “feast day”;

2) Exercise group that participated in five supervised 60 min sessions per week, using elliptical machines and treadmills;

3) Combination of the fasting and exercise interventions;

4) No intervention control group. We measured liver fat using MRI before and after the 3-month intervention.

NEJM: Semaglutide Evaluated for Pediatric Obesity Interview with:
Prof. Dr. Daniel Weghuber
Head of Department
Department of Pediatrics
Paracelsus Medical University
President of the European Childhood Obesity Group

Prof. Dr. Weghuber  What is the background for this study? 

Response: In this study, researchers looked at the effect of semaglutide on body mass index (BMI) and weight loss compared to a dummy medicine (placebo).

ObesityWeek: Setmelanotide (IMCIVREE™) Successfully Induced Weight Loss in Patients With Hypothalamic Obesity

Patients were able to stay away from food for a longer time. For some of the patients that was really changing their lives. They are back to normal and not obsessed with food all the time. Interview with:
Dr. Christian Roth, MD
Seattle Children’s Research Institute and Division of Endocrinology
Department of Pediatrics
University of Washington

Dr. Christian Roth, MD
Seattle Children’s Research Institute and Division of Endocrinology
Department of Pediatrics
University of Washington
Dr. Roth  What is the background for this study? Would you briefly explain what is meant by Hypothalamic Obesity?

Response: Hypothalamic obesity is a different entity of obesity that is rare and very difficult to treat. It is an acquired form of obesity due to injury to the hypothalamus because of a brain tumor and/or its treatment. This causes an abrupt change in body weight regulation because tissues that are important for energy homeostasis are partially or completely removed.

Typically, these patients can’t control their appetite and within a very short time after surgery they gain weight quickly. Their energy expenditure is also very low. So even if they cut down on calorie intake, they are typically not able to lose weight.

Gender Differences in Weight Loss with Medical Treatments

females lost more weight than males with similar exposures to liraglutide, suggesting that body size may not be the only factor. Interview with:
A/Prof Samantha L Hocking | Associate Professor Diabetes NSW & ACT
Sydney School of Medicine (Central Clinical School)
Charles Perkins Centre
Faculty of Medicine and Health
President National Association of Clinical Obesity Services  What is the background for this study? 

Response: Numerous studies have shown that the mean response to a weight loss intervention hides significant individual variation. There are biological and physiological differences between males and females so gender is a potential predictor of weight loss outcomes. 

Genetic Platform Can Allow Some Meds to Be Repurposed for Obesity and Type 2 Diabetes

In the current project we developed genetically informed repurposed medications to tackle obesity and type 2 diabetes (T2D) Interview with:
Professor Murray Cairns. 
Sahar El Shair, PhD student
University of Newcastle, NSW, Australia  What is the background for this study? 

Response: The background is that we want to improve global health by making a significant impact on chronic disease. Many of these complex disorders have a substantial genetic risk but this risk involves hundreds of genes (unlike the simple genetic disorders that people are more familiar with caused by a single gene) and manifests differently in different people.

To break through this problem we developed a platform for aggregating and scoring an individual’s risk for complex disorders in gene networks that can be modulated by drugs. This includes new drugs, existing drugs and those that are currently used for other conditions.