New Frontiers in Nutritional and Therapeutic Interventions for Obesity Phenotypes.

Ioana-Cristina Bica, Ali Abbas Rizvi, Teodor Salmen, Angelo Maria Patti, Anca Pantea Stoian, Rosaria Vincenza Giglio, Marcello Ciaccio, Manfredi Rizzo, Imran Rangraze, Mohamed El Tanani

Journal: Medicina (Kaunas, Lithuania) 2025;61(4):

PMID: 40282955

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Abstract

The heterogeneity among patients with obesity is particularly evident in the weight loss response to interventions such as diets, drugs, devices and surgery. Obesity can be "catalogued" into four phenotypes: hungry brain (abnormal satiety for alteration of gut-brain axis), emotional hunger (hedonic eating), hungry gut (abnormal duration of satiety for faster gastric emptying) and slow burning (slowing of the metabolic rate). Phenotypes are grafted onto this complexity, the recognition of which allows for personalized medicine and increasingly targeted therapies. Although there are no standardized treatment protocols, we present management options consisting of lifestyle modifications and pharmacologic therapies. Nutritional advice and encouragement of adequate physical activity lead to increased self-efficacy and promote a sense of well-being when coupled with psychological approaches involving mindful eating. In summary, obesity has a complex pathophysiology best addressed through a therapeutic process suited to the phenotype encountered and in synergy with multifactorial interventions.

Address: Internal Medicine Unit, "Vittorio Emanuele II" Hospital, 91022 Castelvetrano, Italy.; Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90133 Palermo, Italy.; Department of Laboratory Medicine, University Hospital, 90127 Palermo, Italy.; Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.; Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.; Internal Medicine Department, College of Medical Sciences, Ras Al Khaimah Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah 11172, United Arab Emirates.; Internal Medicine Department, College of Medical Sciences, Ras Al Khaimah Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah 11172, United Arab Emirates.; Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (Promise), University of Palermo, 90133 Palermo, Italy.; Unit of Diabetes and Cardiometabolic Prevention, University Hospital, 90127 Palermo, Italy.; Department of Medicine, Division of Endocrinology, Orlando VA Medical Center and University of Central Florida College of Medicine, Orlando, FL 32827, USA.

DOI: 10.3390/medicina61040664

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https://medlineplus.gov/obesity.html

MeSH Terms: Humans, Obesity, Phenotype, Weight Loss