- KOREAN
- P-ISSN2951-0333
- E-ISSN2951-0597
Vol.3 No.2
Abstract
Wegovy®️, an anti-obesity medication approved in South Korea in April 2023, has attracted attention for its significant weight loss and cardiovascular benefits. However, concerns regarding its misuse have arisen since its release. The drug is being prescribed through telemedicine and sold illegally online, often to individuals without obesity who seek it for cosmetic purposes, and sometimes without proper medical supervision. This misuse increases the risk of serious side effects, including gastrointestinal issues and potential complications such as cholecystitis and pancreatitis. Furthermore, the misuse of Wegovy®️ exacerbates health inequalities. Due to distorted pricing, patients who truly need the treatment may have to pay additional costs beyond the appropriate price, or face difficulty accessing the drug together. This situation can create disparities in access to medication based on socioeconomic status. Health authorities should recognize obesity as a chronic condition that significantly impacts public health. They should seriously consider policy changes to provide health insurance coverage for obesity treatment and medication, especially for individuals with severe cases. Stricter regulations on online sales, telemedicine prescriptions, and increased public awareness are also essential to prevent misuse and improve access for those in genuine need. Additionally, continuous monitoring of drug usage and adverse events is crucial to ensure its proper use. Ultimately, a collaborative effort from the medical community, the public, and health authorities is necessary to ensure the appropriate use of Wegovy®️, minimize health risks, and improve equitable access to treatment for obesity.
Abstract
Obesity is an established risk factor for breast cancer, with particular significance in postmenopausal women. The pathophysiology involves estrogen production in adipose tissue after menopause, leptin-mediated tumor cell proliferation, chronic inflammation, and insulin resistance. Obesity can also develop post-diagnosis and during treatment, with younger premenopausal women more susceptible to weight gain. Weight gain was more common in women who had used certain chemotherapy regimens. While endocrine therapies such as tamoxifen or aromatase inhibitors do not significantly contribute to weight gain, they may elevate the risk of type 2 diabetes and cardiovascular disease. Obese breast cancer survivors demonstrate increased incidence of lymphoedema, cancer recurrence, and mortality compared to normal-weight counterparts. Multidisciplinary interventions incorporating dietary modification, physical activity, and psychosocial support have shown efficacy in weight reduction and quality of life improvement. Therefore, weight management strategies should be integrated early in breast cancer treatment protocols. Further research is needed to determine whether obesity interventions can mitigate breast cancer recurrence or mortality, assess long-term weight loss maintenance, and identify optimal body mass index targets to minimize complications. High-quality, longitudinal intervention studies are crucial to address these questions and enhance outcomes for breast cancer patients and survivors.
Abstract
As urbanization accelerates around the world, the impact of pollutant emissions and air pollution on obesity is becoming increasingly important. Particulate matter (PM) is a major component of substances that cause air pollution, and recent studies have reported that PM affects obesity and obesity-related metabolic disorders. The main mechanisms include chronic inflammation in the hypothalamus, adipose tissue, skeletal muscle, and mitochondria, and oxidative stress in the white adipose tissue, lungs, and thyroid, as well as activation of genes related to lipogenesis, changes in adipose tissue distribution, dysbiosis of intestinal microbiome, and dysfunction of circadian rhythm are also proposed. Therefore, alleviation of air pollution, including reduction of PM concentration, could be a potential strategy for treating obesity and preventing obesity-related complications. Further prospective longitudinal study on human subjects is needed to clearly investigate the effects of PM on the risk of obesity and related mechanisms.
Abstract
Dementia imposes significant personal and social burdens as the aging population increases. Dementia progression has a large impact on the lives of individuals, their families, and people around them. As treatment options for dementia are limited, strategies to prevent or delay its onset are important. Obesity is linked to cognitive decline and dementia, including Alzheimer’s disease, and can induce brain atrophy, vascular damage, chronic inflammation, or alter metabolic functions (e.g., insulin resistance). Previous studies have shown that mid-life obesity is detrimental to cognitive function and increases the risk of dementia. However, the impact of late-life obesity on the risk of dementia is controversial. The findings suggested that the impact of obesity on cognitive function varies across age groups, and factors other than body mass index should be considered when assessing obesity in old age. Based on recent studies, being underweight, unintentional weight loss, weight variability and sarcopenia are associated with an increased risk of dementia in old age, whereas being overweight and obese in old age reduces the risk of dementia. Prevention strategies such as physical activity, weight management, and dietary interventions in mid-life can improve cognitive functions and reduce dementia risk in late life. Diabetes medications, particularly glucagon-like peptide-1 receptor agonists, can reduce dementia risk. Overall, the findings demonstrated the importance of early intervention and consistent weight management across a lifespan for cognitive health.
Abstract
Obesity is a complex, multifactorial condition associated with increased risks of various diseases and higher all-cause mortality. It contributes to the development of numerous comorbidities and adverse clinical outcomes and is reciprocally influenced by certain medical conditions, further complicating effective weight management. Core management strategies include dietary, physical activity, and behavioral interventions, with pharmacotherapy and bariatric surgery serving as adjuncts to enhance weight loss and improve long-term maintenance. As of 2024, several anti-obesity medications (AOMs) have been approved in Korea, including orlistat, naltrexone/bupropion, phentermine/topiramate, and nutrient-stimulated hormone (NuSH)-based AOMs e.g., liraglutide, semaglutide, and tirzepatide. Selection of AOMs requires careful consideration of individual comorbidities to optimize therapeutic outcomes while minimizing adverse effects. For patients without comorbidities, all AOMs are viable options NuSH-based AOMs are primarily recommended for patients with type 2 diabetes or prediabetes due to their superior efficacy, though other AOMs may also be considered. For individuals at high risk of cardiovascular disease, NuSH-based AOMs with demonstrated efficacy in reducing major adverse cardiovascular events are preferred. In patients with psychiatric disorders, all AOMs should be used with caution and under close monitoring. AOMs are contraindicated in patients with severe hepatic or renal impairment and in pregnant or breastfeeding women. Personalized, comorbidity-focused pharmacological strategies are essential to achieve significant and sustainable weight loss. This review explores the role of tailored pharmacotherapy in obesity management, emphasizing the importance of individualized treatment approaches to address the unique health profiles of individuals with obesity and improve therapeutic outcomes.
Abstract
Obesity is closely associated with liver disease and is a major cirrhosis aggravating factor. This case report aimed to evaluate the treatment strategy for obesity and its clinical effects in a patient with concurrent obesity and cirrhosis. After 3 months of treatment with liraglutide and phentermine/topiramate, the patient's body weight decreased by 8 kg (6.7%), and the body mass index (BMI) was reduced from 37.3 to 34.9 kg/m². The albumin level increased by 0.8 mg/dL, reflecting a 25% improvement compared to baseline. The prothrombin time, measured as International Normalized Ratio (INR), decreased by 0.12 units (8.6%), and the Model for End-Stage Liver Disease-Na (MELD-Na) score improved significantly, decreasing from 16 to 11. This case report highlights the impact of early intervention for obesity in a young patient with obesity and cirrhosis, as well as the effects of obesity medications on liver fibrosis. Our findings showed that considering the pharmacological properties and weight loss effect of obesity drugs, they may become an important therapeutic option for the management of liver fibrosis. However, more research is needed to evaluate their efficacy.