Obesity represents a major public health challenge globally. Its diffusion is constantly increasing, not only in Western countries, but also in low-middle income countries; Furthermore, obesity represents a significant risk factor for various chronic diseases. It should be considered not only as a health risk, but as a chronic, progressive and relapsing disease, even in the absence of complications in the initial stages.
Obesity often causes serious complications that can reduce life expectancy, including cardiovascular disease and type 2 diabetes.
The treatment of obesity, therefore, must aim not only at weight loss, but also at the prevention and treatment of complications, with the aim of improving the patient’s quality of life in a lasting way.
Until now, the fight against obesity relied exclusively on traditional strategies based on diet and physical exercise.
The new paradigm in obesity treatment focuses on a more integrated and personalized approach.
Obesity is a chronic disease that requires long-term management; it is associated with many serious health consequences and reduced life expectancy.
In particular, it is closely linked to the increased risk of cardiovascular diseases, including myocardial infarction and stroke, and mortality. Globally, the prevalence of obesity is expected to reach over 1.5 billion adults in 2035, thus also leading to an increase in deaths related to cardiovascular diseases. Unfortunately, the Italian situation appears to be in line with this trend, to date 11.4% of the population lives with obesity, and of these 80% live with heart failure and preserved ejection fraction. The combination is very dangerous, because it can increase the risk of fatal cardiovascular events by up to 85%, ‘stealing’ at least 6 years of life expectancy.
The arrival of a new class of drugs, GLP-1 analogues, seems to represent a turning point in the treatment of excess weight in a short time, together with notable advantages for cardiovascular and metabolic health, all with relatively side effects contents.
During the Symposium ‘Innovative solutions on patient care’ organized by Novo Nordisk within the XXIII Congress of the Association of Endocrinologists, the point was made about why semaglutide represents a new paradigm in the treatment of obesity.
“We are seeing dramatic improvements in the treatment of obesity and related conditions.” – comments Dr. at the end of the symposium. Renato C. Cozzipresident of the AME Association of Endocrinologists.”
The introduction of new drugs has revolutionized the therapeutic approach, making a 360° change in strategy essential. These therapeutic solutions – especially in obesity – allow increasingly effective control of the disease, reducing risk factors for the onset of pathologies such as, for example, cardiovascular ones, preventing the progression towards diabetes in high-risk patients and improving significantly improve patients’ quality of life.
The treatment of obesity in particular is currently experiencing a historic phase. Thanks to research and innovation it is possible not only to reduce body weight, but to holistically manage the person suffering from obesity taking into account their entire state of health.
Results recently published in The Lancet, coming from a cumulative analysis of the STEP HFpEF, STEP HFpEF-DM, SELECT and FLOW studies, show that semaglutide statistically significantly reduces the combined risk of cardiovascular mortality or heart failure events in patients with heart failure cardiac with preserved or slightly reduced ejection fraction.
The analysis included 3,743 participants with heart failure with preserved ejection fraction from the STEP HFpEF, STEP HFpEF-DM, SELECT and FLOW studies. In the STEP HFpEF study, people enrolled had HFpEF related to obesity, in the STEP study HFpEF-DM was related to obesity and type 2 diabetes, while the SELECT study included participants with established cardiovascular disease and overweight or obesity and the FLOW study with type 2 diabetes 2 and chronic kidney disease.
In participants of the studies analyzed semaglutide reduced the risk of the composite outcome of cardiovascular death or worsening heart failure events by 31% and the risk of worsening heart failure alone by 41%. The results obtained in relation to death
cardiovascular were not statistically significant.
People living with HFpEF may experience disabling symptoms and physical limitations and are at high risk of hospitalization and death, especially those who also suffer from obesity, type 2 diabetes, or both. Obesity is considered an important risk factor in the development of HFpEF, so much so that approximately 80% of people who suffer from it are obese. Type 2 diabetes is also often present in people with HFpEF.
