Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany.
Department of Internal Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany; Department of Internal Medicine III, University Hospital Carl Gustav Carus Dresden, Dresden, Germany.
Pharmacol Ther. 2023 Nov;251:108549. doi: 10.1016/j.pharmthera.2023.108549. Epub 2023 Oct 23.
Obesity and its comorbidities, including type 2 diabetes mellitus, cardiovascular disease, heart failure and non-alcoholic liver disease are a major health and economic burden with steadily increasing numbers worldwide. The need for effective pharmacological treatment options is strong, but, until recently, only few drugs have proven sufficient efficacy and safety. This article provides a comprehensive overview of obesity and its comorbidities, with a special focus on organ-specific pathomechanisms. Bariatric surgery as the so far most-effective therapeutic strategy, current pharmacological treatment options and future treatment strategies will be discussed. An increasing knowledge about the gut-brain axis and especially the identification and physiology of incretins unfolds a high number of potential drug candidates with impressive weight-reducing potential. Future multi-modal therapeutic concepts in obesity treatment may surpass the effectivity of bariatric surgery not only with regard to weight loss, but also to associated comorbidities.
肥胖及其合并症，包括 2 型糖尿病、心血管疾病、心力衰竭和非酒精性肝病，是全球范围内一个主要的健康和经济负担，其发病率在稳步上升。因此，人们强烈需要有效的药物治疗选择，但直到最近，只有少数药物被证明具有足够的疗效和安全性。本文全面概述了肥胖及其合并症，特别关注了特定器官的发病机制。减重手术作为迄今为止最有效的治疗策略，本文将讨论当前的药物治疗选择和未来的治疗策略。人们对肠道-大脑轴的认识不断加深，特别是肠降血糖素的发现和生理学，为具有显著减重潜力的大量潜在药物候选物提供了可能。未来肥胖治疗的多模式治疗概念可能不仅在减重方面，而且在相关合并症方面，超越减重手术的疗效。
