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Endocrine Abstracts (2017) 49 S24.2 | DOI: 10.1530/endoabs.49.S24.2

Spain.


A complex interaction between environmental and genetic/epigenetic factors is driving the escalating obesity and diabetes epidemics together with a multitude of associated comorbidities. In the past decades the role of gastrointestinal signals in energy homeostasis and glucose control has made tangible progress mainly due to the findings derived from bariatric/metabolic surgery. In particular, incretin-based approaches in relation with glucagon-like peptide 1 and amylin have fostered the emergence of new treatment avenues. Interestingly, one of the most challenging obstacles in obesity treatment is maintaining a lower body weight after weight loss. It can be argued that weight loss and its maintenance may be uncoupled biological processes that require different pharmacological approaches. Thus, the reduction in metabolic rate triggered by a high calorie-restriction-induced weight loss, contributes to powerful counter-regulatory ‘homeostatic’ mechanisms leading to weight regain. Therefore, innovative strategies aimed at effectively minimizing these compensatory adaptations with combinations of drugs (combos) using different mechanisms of action may prove useful. Consequently, targeting of food hedonics in combination with the archetypical anorectic and thermogenic pathways will probably provide unparalleled pharmacological efficacy to combat obesity and prevent weight regain. Glucagon has reemerged in weight loss polypharmacy relevantly complementing thermogenic agents. Fibroblast growth factors (FGFs) are undoubtedly among a plethora of newly identified metabolic macromolecules. Evidence that brown adipose tissue exists in adult humans and is activated after cold exposure has opened the interest in the potential browning of adipose tissue and the quantitative contribution of BAT induction/activation towards energy expenditure in obesity. Novel insights that facilitate the design of refined polypharmacy that relevantly targets food hedonics at the same time as stimulates energy expenditure without severe off-target effects that are currently frequently linked to behavioral pharmacology are being pursued.

Volume 49

19th European Congress of Endocrinology

Lisbon, Portugal
20 May 2017 - 23 May 2017

European Society of Endocrinology 

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