Department of Comparative Medicine, Yale School of Medicine, New Haven, CT 06520, USA.
Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, USA.
Endocrinology. 2024 Sep 26;165(11). doi: 10.1210/endocr/bqae128.
For centuries, increasingly sophisticated methods and approaches have been brought to bear to promote weight loss. Second only to the Holy Grail of research on aging, the idea of finding a single and simple way to lose weight has long preoccupied the minds of laymen and scientists alike. The effects of obesity are far-reaching and not to be minimized; the need for more effective treatments is obvious. Is there a single silver bullet that addresses this issue without effort on the part of the individual? The answer to this question has been one of the most elusive and sought-after in modern history. Now and then, a miraculous discovery propagates the illusion that a simple solution is possible. Now there are designer drugs that seem to accomplish the task: we can lose weight without effort using mono, dual, and triple agonists of receptors for glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic peptide (GIP), and glucagon. There are, however, fundamental biological principles that raise intriguing questions about these therapies beyond the currently reported side-effects. This perspective reflects upon these issues from the angle of complex goal-oriented behaviors, and systemic and cellular metabolism associated with satiety and hunger.
几个世纪以来,人们一直在不断地研究和尝试各种方法来促进体重减轻。除了研究衰老的圣杯之外,寻找一种简单而有效的减肥方法一直是外行人甚至科学家都关注的焦点。肥胖的影响是深远的,不容忽视;显然需要更有效的治疗方法。是否有一种单一的方法可以解决这个问题,而不需要个人付出努力?这个问题的答案一直是现代历史上最难以捉摸和最受追捧的问题之一。时不时地,一项神奇的发现会让人产生一种错觉,认为有一种简单的解决方案是可能的。现在有了设计药物,似乎可以完成这项任务:我们可以毫不费力地使用胰高血糖素样肽-1 (GLP-1)、葡萄糖依赖性胰岛素释放肽 (GIP) 和胰高血糖素的单、双和三受体激动剂来减肥。然而,除了目前报道的副作用之外,这些治疗方法还存在一些基本的生物学原理,这引发了人们对这些治疗方法的质疑。从与饱腹感和饥饿感相关的复杂目标导向行为以及系统和细胞代谢的角度来看,本文反映了这些问题。