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Recent advances in clinical practice challenges and opportunities in the management of obesity
  1. Andres Acosta1,
  2. Barham K Abu Dayyeh1,
  3. John D Port2,
  4. Michael Camilleri1
  1. 1Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic College of Medicine, Rochester, Minnesota, USA
  2. 2Division of Neuroradiology, Department of Radiology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
  1. Correspondence to Professor Michael Camilleri, Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Charlton 8-110, 200 First St. S.W., Rochester, MN 55905, USA; camilleri.michael{at}mayo.edu

Abstract

Despite advances in understanding the roles of adiposity, food intake, GI and adipocyte-related hormones, inflammatory mediators, the gut–brain axis and the hypothalamic nervous system in the pathophysiology of obesity, the effects of different therapeutic interventions on those pathophysiological mechanisms are controversial. There are still no low-cost, safe, effective treatments for obesity and its complications. Currently, bariatric surgical approaches targeting the GI tract are more effective than non-surgical approaches in inducing weight reduction and resolving obesity-related comorbidities. However, current guidelines emphasise non-surgical approaches through lifestyle modification and medications to achieve slow weight loss, which is not usually sustained and may be associated with medication-related side effects. This review analyses current central, peripheral or hormonal targets to treat obesity and addresses challenges and opportunities to develop novel approaches for obesity.

  • OBESITY
  • BRAIN/GUT INTERACTION
  • GASTROINTESTINAL HORMONES

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