Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK.
School of Medicine, University of Ulster, Ulster, UK.
Clin Med (Lond). 2023 Jul;23(4):337-346. doi: 10.7861/clinmed.2023-0144.
Obesity is a chronic disease associated with increased morbidity and mortality. Bariatric surgery can lead to sustained long-term weight loss (WL) and improvement in multiple obesity-related complications, but it is not scalable at the population level. Over the past few years, gut hormone-based pharmacotherapies for obesity and type 2 diabetes mellitus (T2DM) have rapidly evolved, and combinations of glucagon-like peptide 1 (GLP1) with other gut hormones (glucose-dependent insulinotropic polypeptide (GIP), glucagon, and amylin) as dual or triple agonists are under investigation to enhance and complement the effects of GLP1 on WL and obesity-related complications. Tirzepatide, a dual agonist of GLP1 and GIP receptors, marks a new era in obesity pharmacotherapy in which a combination of gut hormones could approach the WL achieved with bariatric surgery. In this review, we discuss emerging obesity treatments with a focus on gut hormone combinations and the concept of a multimodal approach for obesity management.
肥胖是一种与发病率和死亡率增加相关的慢性疾病。减重手术可以带来持续的长期体重减轻（WL），并改善多种肥胖相关并发症，但它在人群层面上不可扩展。在过去的几年中，基于肠道激素的肥胖和 2 型糖尿病（T2DM）药物治疗迅速发展，将胰高血糖素样肽 1（GLP1）与其他肠道激素（葡萄糖依赖性胰岛素释放肽（GIP）、胰高血糖素和胰淀素）联合作为双重或三重激动剂进行研究，以增强和补充 GLP1 对 WL 和肥胖相关并发症的作用。Tirzepatide 是 GLP1 和 GIP 受体的双重激动剂，标志着肥胖药物治疗的新时代，即肠道激素的联合应用可以接近减重手术所实现的 WL。在这篇综述中，我们讨论了新兴的肥胖治疗方法，重点是肠道激素联合治疗以及肥胖管理的多模式方法的概念。
