Solving Obesity: New Drugs Can’t Change How Little We Know

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Everyone’s talking about weight loss drugs -- but, there’s still a lot we don’t know about obesity, including what’s behind a spike in obesity rates over the past 30-plus years and how to prevent obesity in the first place. What to know:

The craze began when word leaked about Hollywood types using Ozempic and Wegovy to drop weight. Like a Southern California wildfire, news spread: These injectable drugs could help people lose 10%, 15%, or even 20% of their body weight.

Heck, researchers aren’t even sure how this class of drugs – GLP-1 agonists – works for weight loss. Diabetes was the original target, and weight loss effects were a surprise. “The underlying cause [of obesity], and therefore the issues that would guide prevention, are very difficult,” said Randy Seeley, PhD, director of the National Institutes of Health-funded Michigan Nutrition Obesity Research Center. “We’ve run lots of different trials to do obesity prevention, and almost all have been abject failures.”Overeating may be the most widely accepted explanation for rising obesity numbers. It feels intuitive: We eat too much and move too little.

When you consider our growing body sizes, “the data suggest that Americans have been eating relatively less,” the paper notes. It says there’s little evidence to suggest physical activity has changed either, undermining the idea that declining exercise could be a driver. An alternate explanation: The quality of our food intake – like all those sugars and processed carbs – may have changed our bodies’ response to food.

“It was the discovery of leptin that changed things … that said it’s not just willpower; there’s biology at work,” said James Hill, PhD, director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham. “A lot of scientists started saying, ‘Wow, this problem of obesity is pretty interesting. I might want to look at it.’”

 

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