Obesity has more nuances than you think, corresponding to as many biological processes. Knowing it will help to cure it and prevent it better.
To counteract obesity, you have to know it, and perhaps we didn’t know it enough. This pathology could exist in 11 different varieties, each of which corresponding to a different biological mechanism that went wrong. This is suggested by a study by the Broad Institute of Cambridge, Massachusetts, which invites you to look beyond the concept of excess weight to understand the processes at the base of obesity, so as to face it with more targeted treatments. The research appeared in pre-publication on Medrxiv.
Obesity: beyond the canonical definitions
WHO defines obesity a complex chronic disease characterized by excess fat deposits that negatively affect the quality of life and that can increase the risk of diabetes and cardiovascular diseases, to incur reproductive problems and bone diseases, to have a diagnosis of cancer. Traditionally, for adults, there is talk of obesity for those who have a body mass index, IMC (in English body mass index, BMI), i.e. the relationship between weight (kg) and the square of the height (square meters), equal to or greater than 30.
However, the scientific community has recently concluded that the body mass index may not be sufficient, alone, to describe the health of those suffering from obesity. For example, there are those who present symptoms associated with excess weight, such as respiratory or heart problems, and those who are not suffering from any of these problems (but could suffer in the future). And among patients with obesity, there are those who respond well to care with drugs such as the Ozempic and those who, subjected to these treatments, not lose weight. As if you were facing a treatment for the wrong physiological problem.
Help from genetics
US scientists led an investigation into genes of over 2 million people with obesity, of different ethnic backgrounds, to understand which genetic variations were connected to the body mass index and other measures of the accumulation of weight: the abdominal circumference, the life-window ratio and the circumference of the hips. In total, they identified 743 regions of the genome whose variations were connected to obesity, 86 of which never explored.
The team sought which fabrics were affected by the effects of these variations and concluded that these alterations can be divided into 11 groups, each of which connected to a different biological process: obesity metabolically not healthy, or on the contrary metabolically healthy; Six other types of obesity connected to defects in the production of insulin; Obesity connected to an immune disregulation, or to the hormonal control of appetite and weight, or to the metabolism of lipids.
Towards more effective treatments
Scientists prefer to call these categories endotypes of obesity rather than subtypes, because the second term assumes that one can have only one and not the others, while the obesity of a person could fall into more than one of the cases found. In any case, the distinction will serve to better understand this condition and develop better care and prevention strategies, sew on the biological process that caused it.
