Current Treatments for Patients with Genetic Obesity

by Selleckchem | Oct 10 2023

Obesity derives from impaired central control of body weight, implying interaction between environment and an individual genetic predisposition. Genetic obesities, including monogenic and syndromic obesities, are rare and complex neuro-endocrine pathologies where the genetic contribution is predominant. Severe and early-onset obesity with eating disorders associated with frequent comorbidities make these diseases challenging. Their current estimated prevalence of 5-10% in severely obese children is probably underestimated due to the limited access to genetic diagnosis. A central alteration of hypothalamic regulation of weight implies that the leptin-melanocortin pathway is responsible for the symptoms. The management of genetic obesity has so far been only based, above all, on lifestyle intervention, especially regarding nutrition and physical activity. New therapeutic options have emerged in the last years for these patients, raising great hope to manage their complex situation and improve quality of life. Implementation of genetic diagnosis in clinical practice is thus of paramount importance to allow individualized care. This review describes the current clinical management of genetic obesity and the evidence on which it is based. Some insights will also be provided into new therapies under evaluation.

Comments:

Obesity is a complex condition that arises from a combination of genetic predisposition and environmental factors. While lifestyle interventions, such as changes in nutrition and physical activity, have been the mainstay of management for obesity, there are certain forms of obesity known as genetic obesities that require specialized approaches.

Genetic obesities, including monogenic and syndromic obesities, are rare and complex neuro-endocrine disorders characterized by a predominant genetic contribution. They often present with severe and early-onset obesity, accompanied by eating disorders and frequent comorbidities. However, the estimated prevalence of these genetic obesities, currently ranging from 5% to 10% in severely obese children, may be underestimated due to limited access to genetic diagnosis.

A key aspect of genetic obesity is the central alteration of hypothalamic regulation of weight, specifically involving the leptin-melanocortin pathway. Dysregulation within this pathway contributes to the symptoms observed in individuals with genetic obesities.

Traditionally, the management of genetic obesity has focused primarily on lifestyle interventions, including dietary modifications and increased physical activity. However, in recent years, new therapeutic options have emerged, offering hope for improved management and quality of life for affected individuals. These new therapies are currently being evaluated and show promise in addressing the complex challenges associated with genetic obesities.

The implementation of genetic diagnosis in clinical practice is of utmost importance to enable individualized care for individuals with genetic obesity. Identifying the specific genetic alterations underlying these conditions can help guide treatment strategies and optimize outcomes for patients.

In summary, genetic obesities represent a subset of obesity disorders with a significant genetic component. While lifestyle interventions remain crucial, advancements in understanding the genetic basis of these conditions have opened doors to new therapeutic options. The integration of genetic diagnosis into clinical practice is essential for tailoring management approaches and improving the lives of individuals with genetic obesity.