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Title: Individualised prescription of medications for treatment of obesity in adults.
Austin Authors: Hocking, Samantha;Sumithran, Priya 
Affiliation: Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
Department of Medicine, (St Vincent's Hospital), University of Melbourne, VIC, Fitzroy, Australia
Department of Endocrinology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Department of Surgery, Central Clinical School, Monash University, Level 6, 99 Commercial Rd, Melbourne, Victoria, 3004, Australia.
Issue Date: Oct-2023
Date: 2023
Publication information: Reviews in Endocrine & Metabolic Disorders 2023-10; 24(5)
Abstract: Obesity continues to increase in prevalence globally, driven by changes in environmental factors which have accelerated the development of obesity in individuals with an underlying predisposition to weight gain. The adverse health effects and increased risk for chronic disease associated with obesity are ameliorated by weight loss, with greater benefits from larger amounts of weight reduction. Obesity is a heterogeneous condition, with the drivers, phenotype and complications differing substantially between individuals. This raises the question of whether treatments for obesity, specifically pharmacotherapy, can be targeted based on individual characteristics. This review examines the rationale and the clinical data evaluating this strategy in adults. Individualised prescribing of obesity medication has been successful in rare cases of monogenic obesity where medications have been developed to target dysfunctions in leptin/melanocortin signalling pathways but has been unsuccessful in polygenic obesity due to a lack of understanding of how the gene variants associated with body mass index affect phenotype. At present, the only factor consistently associated with longer-term efficacy of obesity pharmacotherapy is early weight loss outcome, which cannot inform choice of therapy at the time of medication initiation. The concept of matching a therapy for obesity to the characteristics of the individual is appealing but as yet unproven in randomised clinical trials. With increasing technology allowing deeper phenotyping of individuals, increased sophistication in the analysis of big data and the emergence of new treatments, it is possible that precision medicine for obesity will eventuate. For now, a personalised approach that takes into account the person's context, preferences, comorbidities and contraindications is recommended.
DOI: 10.1007/s11154-023-09808-2
ORCID: 0000-0002-2514-9392
Journal: Reviews in Endocrine & Metabolic Disorders
PubMed URL: 37202547
ISSN: 1573-2606
Type: Journal Article
Subjects: Obesity medications
Precision medicine
Weight loss
Appears in Collections:Journal articles

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