Freibothe Ines, Müller Timo Dirk
Medizinische Klinik und Poliklinik IV, Diabetesambulanz, LMU Klinikum, Campus Innenstadt, Ziemssenstr. 5, 80336, München, Deutschland.
Institute for Diabetes and Obesity, Helmholtz Zentrum München, München, Deutschland.
Inn Med (Heidelb). 2025 May;66(5):461-466. doi: 10.1007/s00108-025-01893-6. Epub 2025 Apr 10.
Obesity represents an immense challenge for patients and physicians due to its numerous comorbidities and complications. For a long time, safe and effective pharmacological treatment remained wishful thinking. Bariatric surgery was considered the only option for sustained weight loss; however, with the advent of incretin-based treatment, initially introduced as a highly effective component of anti-diabetic treatment, research began to focus on the complex gastroenteropancreatic endocrine system, including central hunger and satiety regulation. This shift was driven by the discovery of a remarkable side effect: placebo-controlled weight reduction. Subsequent groundbreaking pharmacological developments based on long-acting peptides, the administration of which could be reduced from twice daily in earlier forms of treatment to once weekly, now enables significant weight reduction of over 20%, with a tolerable safety profile. This article provides an illustrative overview of the corresponding associations and highlights this milestone in obesity treatment.
肥胖因其众多的合并症和并发症,给患者和医生带来了巨大挑战。长期以来,安全有效的药物治疗一直只是美好的愿望。减肥手术曾被认为是持续减重的唯一选择;然而,随着基于肠促胰岛素的治疗方法的出现,这种治疗最初作为抗糖尿病治疗的高效组成部分被引入,研究开始聚焦于复杂的胃肠胰内分泌系统,包括中枢性饥饿和饱腹感调节。这一转变是由一个显著的副作用的发现所推动的:即安慰剂对照下的体重减轻。随后基于长效肽的开创性药物研发,其给药频率从早期治疗形式的每日两次减少到每周一次,现在能够实现超过20%的显著体重减轻,且安全性可耐受。本文对相应的关联进行了说明性概述,并突出了肥胖治疗中的这一里程碑。