Efficacy and Safety of Setmelanotide For Patients with a Rare form of Genetic Obesity

The severe hyperphagia and the feeling of permanent failure due to the situation of being unable to reduce body weight with conservative treatment options (increase exercise, reduce caloric intake) may affect the relationship within the family

WeightControl.com Interview with:
Prof. Dr. Peter Kühnen
Institute for Experimental Pediatric Endocrinology
Charité Universitätsmedizin Berlin
Berlin, Germany

Prof. Dr. Peter Kühnen

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: The leptin melanocortin signaling pathway plays a pivotal role for central appetite regulation. Gene mutations in this pathway are leading to severe hyperphagia and early onset obesity. We present the data of two phase 3 trials, in which patients with POMC/PCSK1 or LEPR deficiency received treatment with the MC4R agonist setmelanotide. In the past, there were centrally acting obesity drugs, like the cannabinoid receptor inhibitor rimonabant, whose use was associated with depression. Therefore, here we present the data about suicidality and depression of the participants during the treatment with the MC4R agonist setmelanotide.

The main finding was that there was no consistent increase in depression or suicidal ideation / behavior of the treated patients. However, in all cases depressive episode or increase in suicidal ideation was related to the medical history of the participants.

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Weight Loss in Low Income Patients in Primary Care Settings

Clinically significant weight loss is possible in underserved, low-income patients in primary care settings.

WeightControl.com Interview with:
Peter Katzmarzyk, Ph.D., FACSM, FAHA, FTOS
Professor and Marie Edana Corcoran Endowed Chair
Pediatric Obesity and Diabetes
Assoc Exec Dir for Population and Public Health Sciences
Pennington Biomedical Research Center
Baton Rouge, LA

WeightControl.com:  What is the background for this study?

Response: Obesity remains one of the greatest public health threats, and there is good evidence that intensive lifestyle interventions should be a primary approach to obesity management and treatment. However, there has been minimal uptake of obesity treatment approaches in primary care, which is the cornerstone of medicine in the US.

WeightControl.com: What are the main findings?

Response: We developed an intervention to reduce calorie intake and increase physical activity that was delivered by health coaches embedded in primary care clinics. The sample was diverse with a large percentage of low-income and African American patients. The results demonstrated that patients in the intensive lifestyle intervention lost approximately 5% of their initial body weight, compared to patients in usual care who lost about 0.5% of their body weight. These weight loss differences between the two groups were maintained out to 2 years, which demonstrates the durability of the intervention.    

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COVID-19 Linked to Difficulty with Weight Control

With the current concerns that the pandemic may lead to increases in obesity rates, it’s important to develop appropriate and large-scale support options for those aiming to manage their weight.

WeightControl.com Interview with:

Dr Sarah-Elizabeth Bennett
Senior Research Associate
Slimming World, UK

WeightControl.com:  What is the background for this study?

Response: This research is part of a larger Health and Wellbeing study, investigating the behaviour changes made by members of Slimming World, the UK’s largest group-based weight management organisation. New members were surveyed regularly over the course of one year and a representative sample of non-members were also surveyed at similar timepoints for comparison. The survey at the six-month point coincided with lockdown, so questions were added to learn more about how lockdown measures had impacted the nation’s health, wellbeing, and lifestyle behaviours. The following findings were based on the responses of 222 members who had completed all 3 surveys to-date and 637 non-members.

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Weight Control: Better to Eat a Big Breakfast than Big Dinner

The importance of the time of day and our internal clock for food intake and energy metabolism is a very exciting research field. Future studies should investigate why we spend so much more energy after breakfast than after dinner

WeightControl.com Interview with:
M. Sc. Juliane Richter
University of Lübeck
Center of Brain, Behavior and Metabolism
Section of Psychoneurobiology

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: The background for this study is that there is still the misbelief that it does not matter when we eat and that the only thing that counts is the energy balance of the whole day. However, since our body has an internal clock and many processes in the body, for example glucose metabolism, are subject to diurnal variations, we investigated whether diet-induced thermogenesis also varies during the course of the day.

Diet-induced thermogenesis is the energy our body spends for the digestion, absorption and transport of nutrients. We found that diet-induced thermogenesis after breakfast is more than twice as high as after dinner. We also investigated whether this difference in time of day depends on the amount of calories consumed. In both cases, high- and low-calorie meals, the body spends more energy after breakfast than after dinner.

breakfast-timing of meals for weight control
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Obesity Prevented and Reversed in Mice By Blocking Cellular Receptor

We are beginning to understand how the blockage of the AHR prevents and reverses obesity, which may lead to a therapeutic treatment of obesity in humans.

WeightControl.com Interview with:
Craig R. Tomlinson, Ph.D.
Director of Genomics & Molecular Biology Shared Resource
Norris Cotton Cancer Center
Geisel School of Medicine at Dartmouth
Dartmouth Hitchcock Medical Center
Lebanon, NH 03756

WeightControl.com:  What is the background for this study?

Response: Obesity, a global epidemic, is a known contributor to numerous diseases, including diabetes, heart disease, and cancer. Preventing and reversing the obesity epidemic would be a critical aid in preventing and treating these diseases.

Our laboratory had discovered that a drug called NF, which was known to block the activity of a cellular receptor called the AHR, prevented obesity in mice fed a high-fat diet. We undertook studies to determine how the AHR, when inhibited by NF, exerted its effects on obesity.

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Is There a Link Between Obesity and Periodontal Disease?

Clinicians should educate patients about the importance of weight control affecting oral/periodontal health.

WeightControl.com Interview with:

Andres Pinto DMD, MPH, MSCE, MBA, FDS RCSEd, FICD 
Professor and Chair
Oral and Maxillofacial Medicine and Diagnostic Sciences
Director, Oral Medicine Internship and MSD Program

University Hospitals Cleveland Medical Center
Assistant Dean for Graduate Studies
Case Western Reserve University and
Cleveland Clinic
Health Education Campus
School of Dental Medicine
Cleveland, OH

WeightControl.com:  What is the background for this study?  What are the main findings?

Response: There is  strong association between oral health and systemic health.  Periodontal disease affects almost half of Americans and is characterized by increased inflammation. The focus of our review was to evaluate the association between obesity and periodontal disease, which has been reported earlier, with attention to the effects on the non-surgical management of periodontal disease. Our results indicate both disorders share similar inflammatory characteristics and may be associated.

However, multiple factors mediate this relationship, of course including oral hygiene. We were unable to find conclusive evidence on the impact of obesity on treatment planning for periodontal therapy, although the presumptive common pathophysiology provides an opportunity for active patient education.

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