Recent discoveries on the underlying pathophysiologic processes of obesity have resulted in the identification of various viable pharmacological targets and innovative treatment techniques for addressing the worldwide obesity pandemic and associated comorbidities. However, current pharmaceutical treatments for obesity therapy were limited in number and had a low efficacy/safety profile. As a result, the demand for safer and more effective new agents was pressing. 

Current drugs under development affect targets in many systems and tissues, including the central nervous system, gastrointestinal hormones, adipose tissue, kidney, liver, and skeletal muscle. Other possible antiobesity methods being investigated in addition to pharmacotherapeutics included innovative drug delivery systems, vaccinations, gut microbiome modification, and gene therapy. The current review outlined the pathophysiology of energy homeostasis. It emphasized pathways being investigated in the endeavor to create innovative antiobesity drugs and therapies, although it did not address devices or bariatric procedures. Emerging pharmacologic drugs and alternative techniques targeting these pathways, as well as pertinent studies in animals and people, were discussed in depth. Special attention was placed on therapy alternatives near the end of the development pipeline and closer to the clinic (i.e., compounds that have a higher chance of being added to the therapeutic armamentarium in the near future). Finally, advances in understanding obesity pathophysiology and interindividual variation led to multimodal and individualized approaches to obesity therapy that resulted in safe, effective, and long-term weight loss until the underlying causes of the disease can be discovered and addressed. 

Reference:academic.oup.com/edrv/article-abstract/43/3/507/6407704?redirectedFrom=fulltext

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