Obesity is far more complex than consuming too many calories. Unraveling obesity’s origins and finding effective therapies requires navigating a complex interplay of factors, which is shaping global efforts to combat this health issue. GLP-1 medications have been making headlines lately, but what other exciting developments does biotech have in store for us? 

Why It Matters

The obesity epidemic stems from a combination of lifestyle choices and genetics. Obesity frequently results in comorbidity, which occurs when a person has multiple related diseases. Chronic diseases associated with obesity include:

• Non-alcoholic fatty liver disease
• Hypertension
• Coronary heart disease
• Stroke
• Type 2 diabetes

There is currently no cure for obesity.

Triple Threat

Historically, obesity medications have not adequately addressed comorbidities, such as inflammation, diabetes, and fatty organs. Let’s take a closer look to see how these comorbidities come about.

• Weight gain occurs due to lifestyle choices or genetics.
• During weight gain, chemical signals called adipokines promote chronic inflammation in fat (adipose) tissue.
• Chronic inflammation of fat tissue compromises the body’s ability to regulate blood glucose levels, which promotes type 2 diabetes.
• Excess fat tissue uses oxygen faster than the body can supply, releasing additional inflammatory adipokines and exacerbating insulin resistance.
• When the body has no place to store additional fat, fat cells (adipocytes) accumulate in organs. This visceral fat interferes with insulin production in the pancreas and may lead to non-alcoholic fatty liver disease.

According to the Centers for Disease Control and Prevention (CDC), 36 million Americans have the comorbidity of obesity and type 2 diabetes, and half of this cohort, 18 million, are afflicated with non-alcoholic fatty liver disease.

Applied Science

The following drugs have shown promise as potential obesity therapies:

• AdipoRon is a small molecule drug that stimulates the adiponectin receptor to lower insulin sensitivity and improves the abnormal distribution of adipocytes (fat cells).
• TNF inhibitor drugs inhibit TNF, a key driver of inflammation. TNF inhibitors Remicade and Enbrel may help with glucose control and insulin resistance.
• IL-1 beta inhibitor medication block the proinflammatory IL-1 beta signaling molecule. Two IL-1 beta inhibitors, Anakinra and Ilaris, are being investigated to combat obesity, type 2 diabetes, and insulin resistance.

Emerging Research

There are two types of fat tissue—white and brown. White fat stores energy in big, oily droplets throughout the body, while brown contains smaller droplets and high amounts of mitochondria that burn energy as calories. Converting white adipose tissue to brown adipose tissue is an emerging area in obesity research and therapy.

Cocktail Fodder

The American Liver Foundation estimates 80-100 million adults in the U.S. have fatty liver disease, but many do not know they have it. The two main types of fatty liver disease are alcoholic fatty liver disease and non-alcoholic fatty liver disease. Alcoholic fatty liver disease is caused by—you guessed it—excessive alcohol consumption. While non-alcoholic fatty liver disease is not related to alcohol, but is associated with obesity and insulin resistance.

Take a Refresher

Has it been a minute since you took a science course? Familiarize yourself with the basics of chemical signals, inhibitor drugs, peptides, receptors, and so much more! Refresh your science understanding and take Biotech Primer’s Biology of Biotech 85-minute class.