New research shows that a form of genetic obesity can be countered with a medication that suppresses appetite
Genetic Obesity
We often talk about genetic obesity. It’s a tricky term because what exactly does it mean? Obesity is caused by excessive energy intake and/or low expenditure. Genetic influences can play a role on both sides. They can lead to an unhealthy increase in appetite and/or decreased satiety, resulting in overeating. It’s also possible that the energy intake is less rapidly utilized due to a lower metabolism. In a recent study, Danish researchers focused particularly on the aspect of genetically determined appetite/satiety [3]. It’s important to note that appetite and satiety are influenced by multiple factors. While every new insight is welcome, a singular solution for (genetic) obesity shouldn’t be expected.Genetically Determined Appetite
In individuals with obesity, this develops in two to six cases out of every hundred already in early childhood. At least according to the press release from the University of Copenhagen [1]. It’s in their genes. Mutations in one of their ‘appetite genes’ lead to a significant increase in the likelihood of obesity. Appetite is heightened, and the feeling of satiety is decreased. Treatment methods such as diet and surgery may help, but offer little long-term results. This increased risk of obesity due to a mutation of a single gene is also called monogenic obesity. There aren’t many known mutations that increase the risk of childhood obesity. Many of the known mutations are related to genes involved in the regulation of leptin [2]. Leptin is known for its role in suppressing appetite.New Medication for Genetic Obesity
The researchers from the north targeted a gene that specifically increases appetite. They studied 14 obese individuals caused by mutations in the MC4R gene. These individuals were given the medication liraglutide, which is a modified form of the appetite-suppressing hormone GLP-1. This hormone is released by the intestines when we eat. They compared the effect with 28 people without mutations in the gene. Apart from the medication, no changes were made to their exercise or diet. The results were similar in both groups. They had reduced hunger and lost about six percent of their body weight. On average, individuals lost 6.8 kilograms over 16 weeks in the mutation group and 6.1 kilograms in the non-mutation group. This was remarkable. Obese individuals with the mutation have a defective receptor that normally influences appetite. Liraglutide was supposed to work by stimulating this receptor. This study shows that it must work (also) in a different way.People who have suffered from obesity all their lives probably are not aware that it is caused by this mutation. It can therefore be a huge relief for many to learn why they have developed obesity and that there is actually a treatment that works Eva Winning Iepsen Novo Nordisk Foundation Center for Basic Metabolic Research.Iepsen also points out that the medication should be able to help in controlling blood sugar in individuals with this mutation. Thus, it could also have a preventive effect on (pre-)diabetes in this group. The researchers hope to assist young people with this mutation in preventing obesity.
Predisposition, Environment, and Behavior
Personally, I believe there is still a long way to go in identifying such mutations. Often, they go undiscovered. Weight is often only discussed when it’s already a problem. In an ideal world, for example, you would already know at the age of five what your genetic predisposition is for obesity. Not only regarding your appetite but also your metabolism. Your parents would then know early enough that you need a thoughtful diet and exercise routine. Preventing you from becoming overweight, but also making it clear why you need to work harder to get rid of it. Just transparency. That prevents a lot of disappointment and leads to realistic expectations. Subsequently, it would be great if all these different possible mutations could be recognized, and science would be ready with a remedy. To level the playing field so that a pleasant dinner is no longer torture.References
- https://cbmr.ku.dk/news/2018/study-offers-new-hope-for-the-fight-against-genetically-determined-obesity
- Funcke J-B, von Schnurbein J, Lennerz B, et al. Monogenic forms of childhood obesity due to mutations in the leptin gene. Molecular and Cellular Pediatrics. 2014;1:3. doi:10.1186/s40348-014-0003-1.
- Eva W. Iepsen, Jinyi Zhang, Henrik S. Thomsen, Elizaveta L. Hansen, Mette Hollensted, Sten Madsbad, Torben Hansen, Jens J. Holst, Jens-Christian Holm, Signe S. Torekov. Patients with Obesity Caused by Melanocortin-4 Receptor Mutations Can Be Treated with a Glucagon-like Peptide-1 Receptor Agonist. Cell Metabolism, 2018;
