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Review
. 2019 Jul 27:10:2042018819863022.
doi: 10.1177/2042018819863022. eCollection 2019.

Precision medicine in adult and pediatric obesity: a clinical perspective

Eric M Bomberg  1 , Justin R Ryder  2 , Richard C Brundage  3 , Robert J Straka  3 , Claudia K Fox  2 , Amy C Gross  2 , Megan M Oberle  2 , Carolyn T Bramante  2 , Shalamar D Sibley  4 , Aaron S Kelly  2
Affiliations
Review

Precision medicine in adult and pediatric obesity: a clinical perspective

Eric M Bomberg et al. Ther Adv Endocrinol Metab. .

Abstract

It remains largely unknown as to why some individuals experience substantial weight loss with obesity interventions, while others receiving these same interventions do not. Person-specific characteristics likely play a significant role in this heterogeneity in treatment response. The practice of precision medicine accounts for an individual's genes, environment, and lifestyle when deciding upon treatment type and intensity in order to optimize benefit and minimize risk. In this review, we first discuss biopsychosocial determinants of obesity, as understanding the complexity of this disease is necessary for appreciating how difficult it is to develop individualized treatment plans. Next, we present literature on person-specific characteristics associated with, and predictive of, weight loss response to various obesity treatments including lifestyle modification, pharmacotherapy, metabolic and bariatric surgery, and medical devices. Finally, we discuss important gaps in our understanding of the causes of obesity in relation to the suboptimal treatment outcomes in certain patients, and offer solutions that may lead to the development of more effective and targeted obesity therapies.

Keywords: anti-obesity agents; bariatric surgery; obesity; obesity etiology; precision medicine; weight loss.

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Conflict of interest statement

Conflict of interest statement: J.R.R. received research support in the form of drug/placebo from Boehringer Ingelheim. C.K.F. received research support from Novo Nordisk. S.D.S. received grant funding from Astra Zeneca Pharmaceuticals. A.S.K. received research support (drug/placebo) from Astra Zeneca Pharmaceuticals and served as a consultant for Novo Nordisk, WW, and Vivus Pharmaceuticals but did not accept personal or professional income for these activities. The other authors have no disclosures.

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