Over the past 50 years, cardiometabolic diseases have risen to unseen prevalence. These diseases, encompassing an overlapping set of diseases, such as obesity and diabetes, are a formidable foe worldwide. A commonality amongst cardiometabolic diseases is risk factors like high blood pressure, high blood sugar levels, excess weight around the waist, and elevated cholesterol levels. Thankfully, progression in medicine has led to a wide number of therapies that can treat these diseases, reducing risk factors and prolonging patients’ lives by years. Blood pressure and cholesterol medications are a great example of this.
Obesity – a multi-factorial disease with a difficult tract record for treatment
However, for obesity, one of these cardiometabolic diseases, numerous therapies have offered a glimmer of hope only to come up short or produce profound (and sometimes harmful) side effects [1]. This landscape has shifted with the presence of GLP-1 pharmaceuticals. These medications are the talk of the town changing how obesity is treated. The molecules in these prescriptions mimic the action of a human hormone mostly produced mostly intestines : GLP-1 (glucagon-like peptide-1) and have shown promise in reducing body weight [2] and improving blood glucose control [3].
“these novel obesity medications are effective and have demonstrated unprecedented results, and they should be supported for individuals with obesity!”
Obesity medications – an end to diet and lifestyle therapies?
Just to clear the air upfront: these novel obesity medications are effective and have demonstrated unprecedented results, and they should be supported for individuals with obesity! This article also doesn’t serve to cite commonly used phrases, such as “managing symptoms”, “partial efficacy”, or not addressing “the root cause” that are typically thrown about when speaking about these medications.
Even with their effectiveness, obesity medications have not rendered diet and lifestyle therapies obsolete [4]! To the contrary – clinical evidence for these medications relies on including nutrition and lifestyle intervention [5]. In fact, now is likely the opportune time for precision and personalized nutrition to complement these medications. As with any therapy, individuals respond differently to these medications[6]. Also, it is likely that adding personalized interventions, which would increase actionability and applicability of lifestyle therapy would help individuals taking these medications, even for those responding well. For example, dietary and lifestyle improves the overall quality of life [7], boost mental health [8], and have long-lasting health benefits that go beyond the management of cardiometabolic diseases themselves. Even further, adding a lifestyle therapy can improve maintain weight loss after stopping these medications [9].
“Even with their effectiveness, obesity medications have not rendered diet and lifestyle therapies obsolete [4]!”
Current generation obesity medications are extremely effective and rely on complementary diet and lifestyle therapy
Diet and Lifestyle therapies – a key to prevention
It is also important to mention that while obesity and medications treating this disease have been the focus of the article – these medications are prescribed during or after disease progression. As such, lifestyle therapies remain paramount in preventing and managing these diseases, especially at earlier stages [4]. Prevention is becoming increasingly important not only due to the direct future health effects of these diseases on individuals, but the significant burdens associated once established. Add to the fact that current evidence highlights the need for continual treatment with obesity medications without continued lifestyle therapy [9], prevention for future generations is likely a more sustainable path to tackle these diseases.
Diet and lifestyle prevention programs aim to reduce or reverse the rise in cardiometabolic diseases
Diet and lifestyle therapies – part of the solution to overweight, obesity, and other cardiometabolic diseases
In conclusion, while recent therapeutics and medicines offer significant benefits in preventing and managing cardiometabolic diseases, lifestyle interventions remain an indispensable part of the equation. The integration of both approaches provides the most effective strategy for combating these diseases. Moving forward, fostering environments and technology that support healthy lifestyle choices, such as precision and personalized nutrition, will be crucial in flattening the growing epidemic of cardiometabolic diseases.
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[1] Müller et al., Nat Rev Drug Discov, 21, 3, pp. 201–223, Mar. 2022, doi: 10.1038/s41573-021-00337-8.
[2] Davies et al., The Lancet, 397, 10278, pp. 971–984, Mar. 2021, doi: 10.1016/S0140-6736(21)00213-0.
[3] Yao et al., BMJ, 384, p. e076410, Jan. 2024, doi: 10.1136/bmj-2023-076410.
[4] Elmaleh-Sachs et al., JAMA, 330, 20, pp. 2000–2015, Nov. 2023, doi: 10.1001/jama.2023.19897.
[5] https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 (Accessed Mar. 22, 2024).
[6] Strathe et al., Diabetes, Obesity and Metabolism, 25, 11, pp. 3171–3180, 2023, doi: 10.1111/dom.15211.
[7] https://www.mdpi.com/2072-6643/10/8/971 (Accessed Mar. 22, 2024).
[8] Zerón-Rugerio et al., Proceedings, 91, 1, Art. no. 1, 2024, doi: 10.3390/proceedings2023091380.
[9] Jensen et al., eClinicalMedicine, 69, Mar. 2024, doi: 10.1016/j.eclinm.2024.102475.
