Obesity surgeries are known to have many metabolic side effects as well as benefits. Experts have reported that medical treatments provide weight loss similar to surgical intervention.
Obesity, which is rapidly spreading especially in developed and developing countries, has reached a rate of 30 percent in our country. Although surgical interventions are the first thing that comes to mind when it comes to obesity treatment, recently developed medical treatments also yield successful results. Underlining that some medical treatments increase weight loss by up to 24 percent and some can even reach weight loss close to that provided by bariatric (obesity) surgery, Liv Hospital Vadistanbul Endocrinology and Metabolic Diseases Specialist Prof. Dr. Berçem Ayçiçek, on the other hand, drew attention to the side effects of these treatments and said, “Patients should be carefully informed about the risks in question and the treatment process should be continued under the supervision of a specialist physician.”
Medical Treatment Options for Obesity Are Increasing Rapidly
According to the World Health Organization, the prevalence of obesity, a global health problem that causes various serious illnesses, primarily cardiovascular diseases, has tripled since 1975 and has reached 30 percent in Turkey… While the increase in consumption of high-calorie, processed, industrial foods, portion sizes, physical inactivity, and psychic/physical stress play an important role in the increase in obesity rates, in addition to genetic predisposition, recent studies also point to the “Epigenetic Effect” as the cause of the transfer of obesity from generation to generation. In addition to the health problems it creates, obesity, which also causes an increase in healthcare expenses, accounts for 27 percent of physician visits and outpatient treatment expenses, 46 percent of inpatient treatment expenses, and 80 percent of prescription drug expenses, according to US data. On the other hand, the medical treatment options used in the treatment of obesity have been rapidly increasing in recent years. Stating that these options are an effective approach that increases the success of treatment, Liv Hospital Vadistanbul Endocrinology and Metabolic Diseases Specialist Prof. Dr. Berçem Ayçiçek states that among the expectations from obesity drugs are that they provide effective weight loss in relation to the dose, support the sustainability of the targeted weight and are reliable in long-term use. Prof. Dr. Ayçiçek also noted that the characteristics of these drugs such as not developing tolerance, not causing the risk of abuse or addiction are also very important, and according to Prof. Dr. Ayçiçek, these expectations play a critical role in determining the ideal treatment options that are suitable for patient needs in terms of both effectiveness and safety in the treatment of obesity.
Drugs Are Available That Increase Weight Loss by Up to 24%
Success in obesity treatment can be increased with medical methods that continuously support the weight loss process of patients. Stating that even small amounts of weight loss (5-10 percent) can make a big difference on metabolic health, Prof. Dr. Ayçiçek said, “For example, GLP-1 receptor agonists such as semaglutide and liraglutide provide weight loss between 7 and 17 percent, while also showing positive effects on blood sugar control and cardiovascular health. GLP-1 receptor agonists suppress appetite, delay gastric emptying and increase insulin secretion by binding to GLP-1 receptors in the gastrointestinal system. The drugs we call dual agonist drugs affect another target in addition to GLP-1 receptor agonists, usually containing a combination of GIP (gastric inhibitory polypeptide) or GLP-1. Tirzepatide is in this class and has been observed to increase weight loss rates by up to 20 percent in clinical studies. It is also seen to provide benefits on cardiovascular health. We expect it to be among our treatment options very soon. Triple agonists, It acts on three receptors such as GLP-1, GIP and glucagon and seems to be at the top of the list of medical treatments so far with its weight loss enhancing effect. Retatrutid is a new drug in this group and shows very promising results in clinical trials (Phase 1-2). This drug, which has been observed to increase weight loss by up to 24 percent, supports glucose control by increasing insulin secretion and improves fat metabolism,” he said.
In Which Situations Should GLP-1 Receptor Agonists Not Be Used?
GLP-1 receptor agonists may not be safe in some cases and should not be used. Prof. Dr. Ayçiçek, who lists these conditions as pregnancy, history of pancreatitis, history of medullary thyroid cancer, cholelithiasis (gallstones), and severe renal failure, notes that since such clinical conditions may increase the risk of treatment, the patient's condition should be carefully evaluated and alternative treatment options should be preferred. Prof. Dr. Ayçiçek, who stated that GLP-1 drugs should be used with caution in people with diabetes and eye problems, continued his words as follows: “Rapidly lowering blood sugar can worsen eye problems. These drugs can be effective for treatment, but when making a decision, both the benefits and risks should be evaluated well. In short, in this case, 'proceeding slowly and carefully' is important to protect eye health. There are some publications indicating that semaglutide increases the risk of Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION), which can lead to nerve damage in the eye. Although the JAMA study reported this risk as 7,5 percent, the reliability of the data is questionable because the observed cases are very rare. If only 16 cases are mentioned in approximately 20 thousand patients, it is very difficult to know exactly the frequency and effectiveness of such rare side effects. In such studies, such as retrospective case-control studies, data reliability can sometimes be problematic. In such studies, control group selection and demographic matching processes can make the results misleading. In this respect, it is obvious that longer-term studies with a higher level of evidence are needed.”
Medical Treatments Provide Weight Loss Similar to Surgery
Drugs used in obesity treatment in recent years play an important role in providing effective weight loss. On the other hand, Prof. Dr. Ayçiçek stated that some concerns about the side effects of these drugs are a subject that both doctors and patients should carefully evaluate, and said, “Scientific studies indicate that new medical treatments are close to the weight loss provided by bariatric (obesity) surgery. However, if follow-up and precautions are not taken in the long term, both after bariatric surgery and after long-term use of medical treatments, some serious side effects such as micronutrient deficiencies, muscle loss, psychological problems and fracture risk can occur. For example, common side effects of GLP-1 receptor agonists include nausea, vomiting and abdominal pain, while serious complications such as ischemia-related optic neuropathy are rarely seen.”
Patients Should Be Carefully Informed
Prof. Dr. Ayçiçek, who argues that endocrinologist follow-up is also necessary in obesity treatment to maintain treatment success and minimize side effects, listed the reasons for this as follows: “During the use of GLP-1 receptor agonists, the doctor can increase compliance with the treatment, monitor side effects and determine complications in advance. Long-term follow-up allows rapid intervention in health problems that may occur during the treatment process. In conclusion, although the effects of this drug group in obesity treatment are quite promising, it requires that patients be carefully informed and the treatment process be continued under the supervision of a specialist physician when there is a risk of any side effect related to these treatment options.”
Preventing Obesity Is More Advantageous Than Treating It
Although obesity treatment options are increasing, preventing obesity continues to be much more advantageous than treating it. Stating that establishing healthy eating habits at an early age, encouraging physical activity and increasing awareness of obesity in society are important strategies to reduce the burden of the disease, Prof. Dr. Ayçiçek said, “Measures such as facilitating access to healthy foods, organizing school nutrition programs and urban planning to increase physical activity are the cornerstones of obesity prevention efforts.”
Source: HORECA TREND and Science and Health News Agency