Obesity Medicine Resources

We need an operation warp speed for obesity medicine. Healthcare systems , insurers, and employers are still falling short on our mission of radically changing what obesity looks like in the U.S. and providing access to the full suite of effective obesity treatment interventions including medications that are proven to help patients manage their condition.

Although cardiovascular disease remains a significant concern, many of its risk factors can be managed, and in some cases, even reversed. One of the most effective ways to support heart health is through weight loss.

1 On the other hand, there are other rare types of obesities resulting from some rare but highly impactful genetic variants or deletions (i.e. Bardet- Biedl Syndrome, POMC deficiency, LEPR deficiency, Prader-Willi Syndrome), or even acquired hypothalamic damage (i.e. acquired hypothalamic obesity) ( Figure 1). Rare genetic variants or damage to the hypothalamus can lead to impairment of a critical pathway, the hypothalamic melanocortin-4 receptor (MC4R) pathway, otherwise known as the leptin-melanocortin pathway. This pathway is responsible for regulating hunger and energy expenditure and any impairment in the pathway leads to rare MC4R pathway diseases. 2-3 It is important to be aware of this unique subset of obesity associated with MC4R pathway diseases as MC4R pathway diseases are likely underdiagnosed and early identification of MC4R pathway diseases is essential for optimal disease management. 4-6 Figure 1: Rare Hypothalamic MC4R Pathway Diseases The MC4R signaling pathway regulates hunger, satiety, and energy expenditure, consequently affecting body weight. 7-8 Genetic variants that impair function of genes involved in the MC4R Pathway function, or physical damage to the hypothalamus leads to decreased alpha-MSH and impaired downstream activation of the MC4R pathway. 9 Figure 2: Impairment of the MC4R Signaling Pathway MC4R pathway diseases caused by rare genetic variants are classified as monogenic or syndromic in nature. 10 Monogenic obesity refers to obesity due to variants in single genes (e.g. POMC deficiency, LEPR deficiency, PCSK1 deficiency, SRC1 deficiency, SH2B1 deficiency, etc.) along the MC4R pathway. Syndromic obesity refers to obesity that is also due to genetic variants or deletions in the pathway but also associated with additional phenotypes such as organ-specific developmental abnormalities, such as visual impairment, renal anomalies, cognitive impairment, dysmorphic features, etc. 10-11 Rare Genetic Diseases of Obesity Provider Listing A patient's diagnostic journey can be complex and may take years.