TRENDS IN OBESITY TREATMENT: A REVIEW OF THE LITERATURE FROM THE LAST SIX YEARS

Adam Sobiński; Aleksandra Sadowska; Aleksandra Welkier; Joanna Miśkiewicz; Aleksandra Dudek; Patrycja Pietrusińska; Jakub Moder; Anna Dziewierz; Paula Kwaśniewska; Patrycja Śliwa-Tytko

doi:10.31435/ijitss.4(48).2025.4326

Adam Sobiński MEDAR Private Healthcare Facility in Leczyca, Kilinskiego 4, 99-100 Leczyca, Poland https://orcid.org/0009-0003-3063-5621
Aleksandra Sadowska J. Mikulicz-Radecki University Clinical Hospital in Wrocław, Borowska 213, 50-556 Wrocław, Poland https://orcid.org/0009-0006-6458-1264
Aleksandra Welkier Corten Dental Ltd. in Warsaw, Cybernetyki 19B, 02-677 Warszawa, Poland https://orcid.org/0000-0003-3552-6726
Joanna Miśkiewicz Regional Specialist Hospital in Kielce, Grunwaldzka 45, 25-736 Kielce, Poland https://orcid.org/0009-0002-3300-940X
Aleksandra Dudek Jan Biziel University Hospital No. 2 in Bydgoszcz, Kornela Ujejskiego 75, 85-168 Bydgoszcz, Poland https://orcid.org/0009-0000-2547-3574
Patrycja Pietrusińska Medical University of Silesia in Katowice, Mickiewicza 29, 40-085 Katowice, Poland https://orcid.org/0009-0008-0722-4396
Jakub Moder Warsaw South Hospital, Rotmistrza Witolda Pileckiego 99, 02-781 Warszawa, Poland https://orcid.org/0009-0006-7747-6623
Anna Dziewierz Mazowieckie Dental Center Ltd. in Warsaw, Nowy Zjazd 1, 00-301 Warszawa, Poland https://orcid.org/0009-0006-5632-0427
Paula Kwaśniewska Szpakmed Kochłowice in Ruda Śląska, ul. Radoszowska 163, 41-707 Ruda Śląska, Poland https://orcid.org/0009-0007-2576-7573
Patrycja Śliwa-Tytko Medical University of Lublin, Aleje Racławickie 1, 20-059 Lublin, Poland https://orcid.org/0009-0005-5417-4924

DOI: https://doi.org/10.31435/ijitss.4(48).2025.4326

Keywords: Obesity, GLP-1, Semaglutide, Sleeve Gastrectomy, Gastric Bypass, Psychotherapy

Abstract

Introduction: Obesity is a major health and economic issue, increasing the risk of type 2 diabetes, hypertension, and cardiovascular diseases. This review analyzes recent advances in

obesity treatment, focusing on pharmacotherapy, surgical techniques, minimally invasive methods, and psychotherapy.

Materials and Methods: This review included publications from 2018 to 2024 available in the PubMed and Google Scholar databases. The analysis focused on the efficacy and safety of various therapeutic interventions, including modern pharmacological agents, surgical procedures, the use of intragastric balloons, and psychotherapies such as Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT).

Results: New pharmacotherapies, such as semaglutide and tirzepatide, lead to 15–25% weight loss. Surgical techniques like Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) achieve 27–69% excess weight loss (EWL). Intragastric balloons provide a temporary 12–25% EWL. CBT effectively supports weight loss, enhances quality of life, and promotes long-term behavioral changes.

Conclusions: In conclusion, optimal obesity management requires a multifaceted approach that considers the patient’s health status, comorbid conditions, and capacity for lasting lifestyle changes. The integration of pharmacological and surgical interventions with psychotherapeutic methods such as CBT and ACT allows for a more holistic approach to addressing this complex health issue. Future research should focus on the long-term effectiveness of these methods and their synergy, which could contribute to the development of more personalized and effective treatment strategies.

References

World Health Organization. Obesity and overweight [Internet]. 2024 [cited 2024 Nov 29]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Okunogbe A, Nugent R, Spencer G, Powis J, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health. 2022 Sep 20;7(9).

Lau J, Bloch P, Schäffer L, Pettersson I, Spetzler J, Kofoed J, et al. Discovery of the Once-Weekly Glucagon-Like Peptide-1 (GLP-1) Analogue Semaglutide. J Med Chem. 2015 Sep 24;58(18):7370–80.

Hughes S, Neumiller JJ. Oral Semaglutide. Clinical Diabetes. 2020 Jan 1;38(1):109–11.

Blüher M, Aras M, Aronne LJ, Batterham RL, Giorgino F, Ji L, et al. New insights into the treatment of obesity. Diabetes Obes Metab. 2023 Aug 5;25(8):2058–72.

Secher A, Jelsing J, Baquero AF, Hecksher-Sørensen J, Cowley MA, Dalbøge LS, et al. The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. Journal of Clinical Investigation. 2014 Oct 1;124(10):4473–88.

Kushner RF, Calanna S, Davies M, Dicker D, Garvey WT, Goldman B, et al. Semaglutide 2.4 mg for the Treatment of Obesity: Key Elements of the STEP Trials 1 to 5. Obesity. 2020 Jun 22;28(6):1050–61.

Wadden TA, Bailey TS, Billings LK, Davies M, Frias JP, Koroleva A, et al. Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity. JAMA. 2021 Apr 13;325(14):1403.

Syed YY. Tirzepatide: First Approval. Drugs. 2022 Jul 13;82(11):1213–20.

Anglart G, Janik L, Dettlaff K. Tirzepatide – a new analogue of incretin hormones. Farm Pol. 2023;79(5):289–96.

Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide Once Weekly for the Treatment of Obesity. New England Journal of Medicine. 2022 Jul 21;387(3):205–16.

Rosenstock J, Wysham C, Frías JP, Kaneko S, Lee CJ, Fernández Landó L, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. The Lancet. 2021 Jul;398(10295):143–55.

le Roux CW, Zhang S, Aronne LJ, Kushner RF, Chao AM, Machineni S, et al. Tirzepatide for the treatment of obesity: Rationale and design of the SURMOUNT clinical development program. Obesity. 2023 Jan 1;31(1):96–110.

Garvey WT, Frias JP, Jastreboff AM, le Roux CW, Sattar N, Aizenberg D, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. The Lancet. 2023 Aug;402(10402):613–26.

Wadden TA, Chao AM, Machineni S, Kushner R, Ard J, Srivastava G, et al. Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity: the SURMOUNT-3 phase 3 trial. Nat Med. 2023 Nov 1;29(11):2909–18.

Aronne LJ, Sattar N, Horn DB, Bays HE, Wharton S, Lin WY, et al. Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity. JAMA. 2024 Jan 2;331(1):38.

Jastreboff AM, Kaplan LM, Frías JP, Wu Q, Du Y, Gurbuz S, et al. Triple–Hormone-Receptor Agonist Retatrutide for Obesity — A Phase 2 Trial. New England Journal of Medicine. 2023 Aug 10;389(6):514–26.

A Study of Retatrutide (LY3437943) in Participants Who Have Obesity or Overweight (TRIUMPH-1) [Internet]. [cited 2024 Nov 30]. Available from: https://clinicaltrials.gov/study/NCT05929066?term=retatrutide&aggFilters=phase:3&rank=4

A Study of Retatrutide (LY3437943) in Participants With Type 2 Diabetes Mellitus Who Have Obesity or Overweight (TRIUMPH-2) [Internet]. [cited 2024 Nov 30]. Available from: https://clinicaltrials.gov/study/NCT05929079?term=retatrutide&aggFilters=phase:3&rank=5

A Study of Retatrutide (LY3437943) in Participants With Obesity and Cardiovascular Disease (TRIUMPH-3) [Internet]. [cited 2024 Nov 30]. Available from: https://clinicaltrials.gov/study/NCT05882045?term=retatrutide&aggFilters=phase:3&rank=3

A Study of Retatrutide (LY3437943) Once Weekly in Participants Who Have Obesity or Overweight and Osteoarthritis of the Knee (TRIUMPH-4) [Internet]. [cited 2024 Nov 30]. Available from: https://clinicaltrials.gov/study/NCT05931367?term=retatrutide&aggFilters=phase:3&rank=6

Wharton S, Blevins T, Connery L, Rosenstock J, Raha S, Liu R, et al. Daily Oral GLP-1 Receptor Agonist Orforglipron for Adults with Obesity. New England Journal of Medicine. 2023 Sep 7;389(10):877–88.

Frias JP, Hsia S, Eyde S, Liu R, Ma X, Konig M, et al. Efficacy and safety of oral orforglipron in patients with type 2 diabetes: a multicentre, randomised, dose-response, phase 2 study. The Lancet. 2023 Aug;402(10400):472–83.

A Study of Orforglipron (LY3502970) in Adult Participants With Obesity or Overweight With Weight-Related Comorbidities (ATTAIN-1) [Internet]. [cited 2024 Nov 30]. Available from: https://clinicaltrials.gov/study/NCT05869903?intr=Orforglipron&rank=6 (

Study of Orforglipron in Adult Participants With Obesity or Overweight and Type 2 Diabetes (ATTAIN-2) [Internet]. [cited 2024 Nov 30]. Available from: https://clinicaltrials.gov/study/NCT05872620?intr=Orforglipron&rank=5

Luesma MJ, Fernando J, Cantarero I, Lucea P, Santander S. Surgical Treatment of Obesity. Special Mention to Roux-en-Y Gastric Bypass and Vertical Gastrectomy. Vol. 13, Frontiers in Endocrinology. Frontiers Media S.A.; 2022.

ALEXANDROU A, SAKARELLOS P, DAVAKIS S, VAILAS M, DIMITRIOU N, PAPALAMPROS A, et al. Revision of Roux-en-Y Gastric Bypass for Inadequate Weight Loss or Weight Regain. In Vivo (Brooklyn). 2022 Dec 30;36(1):30–9.

Fink J, Seifert G, Blüher M, Fichtner-Feigl S, Marjanovic G. Obesity Surgery: Weight Loss, Metabolic Changes, Oncological Effects, and Follow-Up. Dtsch Arztebl Int. 2022 Feb 4;119(5):70–80.

Felsenreich DM, Langer FB, Prager G. Weight Loss and Resolution of Comorbidities After Sleeve Gastrectomy: A Review of Long-Term Results. Scandinavian Journal of Surgery. 2019 Mar 6;108(1):3–9.

Grönroos S, Helmiö M, Juuti A, Tiusanen R, Hurme S, Löyttyniemi E, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Roux-en-Y Gastric Bypass on Weight Loss and Quality of Life at 7 Years in Patients With Morbid Obesity. JAMA Surg. 2021 Feb 1;156(2):137.

Glass J, Chaudhry A, Zeeshan MS, Ramzan Z. New Era: Endoscopic treatment options in obesity—a paradigm shift. World J Gastroenterol. 2019 Aug 28;25(32):4567–79.

Mion F, Ibrahim M, Marjoux S, Ponchon T, Dugardeyn S, Roman S, et al. Swallowable Obalon® Gastric Balloons as an Aid for Weight Loss: A Pilot Feasibility Study. Obes Surg. 2013 May 20;23(5):730–3.

Dalle Grave R, Sartirana M, Calugi S. Personalized cognitive-behavioural therapy for obesity (CBT-OB): Theory, strategies and procedures. Vol. 14, BioPsychoSocial Medicine. BioMed Central Ltd.; 2020.

Moraes A dos S, Padovani R da C, La Scala Teixeira CV, Cuesta MGS, Gil S dos S, de Paula B, et al. Cognitive Behavioral Approach to Treat Obesity: A Randomized Clinical Trial. Front Nutr. 2021 Feb 18;8.

Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press; 1999.

Hayes SC, Barnes-Holmes D, Roche B, editors. Relational Frame Theory. Boston, MA: Springer US; 2001.

Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and Commitment Therapy: Model, processes and outcomes. Behaviour Research and Therapy. 2006 Jan;44(1):1–25.

Iturbe I, Echeburúa E, Maiz E. The effectiveness of acceptance and commitment therapy upon weight management and psychological well-being of adults with overweight or obesity: A systematic review. Vol. 29, Clinical Psychology and Psychotherapy. John Wiley and Sons Ltd; 2022. p. 837–56.