A Precision Medicine Approach for Obesity Management

Obesity is a chronic, complex, and multifactorial disease. Considering the elevated morbidity, mortality, and financial implications of obesity, the development of safe and effective weight loss interventions is of utmost importance. Weight loss management modalities include lifestyle interventions, antiobesity medications, and bariatric and metabolic procedures. Across all interventions, there is significant interindividual variability in weight loss outcomes. Gaining insight into this heterogeneity necessitates an initial understanding of the factors that could contribute to differences in outcomes. While lifestyle interventions are the backbone of obesity management, they are often insufficient to achieve and maintain sufficient weight loss. As a result, patients may require additional interventions to achieve clinically significant weight loss accompanied by improvement or resolution of obesity-associated comorbidities. Bariatric surgery remains the most effective intervention for weight loss among patients with obesity. The variability in bariatric outcomes may stem from differences in the body’s homeostatic adaptations to the wide variety of bariatric operations. Multiple hormones secreted by the gastrointestinal tract regulate food intake and demonstrate adaptive post-intervention patterns in patients who have undergone bariatric surgery. Differences in hormonal adaption could partially explain the variability in postsurgical outcomes. Furthermore, precision medicine is based on the practice of customizing medical interventions to target each individuals characteristics and improve patient outcomes. Current evidence for the adoption of a precision medicine framework for obesity management is promising; however, there is still a substantial gap to be addressed before precision medicine is comprehensively integrated into the clinical management of obesity.