Future approaches to treating obesity may differ dramatically from the remedies seen today.

While obesity is certainly nothing new, the condition has grown in prevalence over the past few years, especially in Texas, as previously reported by The Dallas Express.

Among Texas adults, the CDC found that 35.5% were obese as of 2022. Meanwhile, an estimated 17% of Texas children between the ages of 10 and 17 were considered obese in 2021-2022, according to the State of Childhood Obesity.

Clinically defined as having a body mass index of 30 or higher, obesity heightens the risk of type 2 diabetes, heart disease, depression, cancer, and more. Given this significant health threat, brand-new revolutionary weight-loss medications, such as Ozempic, have generated considerable interest from health officials and surging demand among the public, as extensively covered by The Dallas Express.

At the same time, it is still early in the game for weight-loss drugs, and some research has suggested that they may not offer a long-term solution for those looking to treat obesity.

Dr. Beverly Tchang recently provided a peek into what the future might hold for obesity care in an op-ed for Medscape. Tchang, an endocrinologist at Weill Cornell Medicine in New York, identified several directions in which prevention and treatment might be headed in the coming years.

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Prioritizing Calorie Quality Over Quantity

One shift Tchang predicts is that political and medical stakeholders will focus more on what kind of calories Americans are ingesting. Highlighting how weight-loss drugs have already been linked to lower sales for grocers and fast-food chains, she suggested that policies targeting ultra-processed foods and sugar could be on the way.

Research on ultra-processed food consumption has found that calorie quality matters. Those consuming a lot of ultra-processed food tended to eat more calories — around 500 calories more per day — compared to those who ate more unprocessed food. As previously reported by The Dallas Express, another study suggested that the flora in the gut might be behind this, with the body absorbing significantly fewer calories from an unprocessed diet than a highly processed one.

Weight-loss Drugs Will Be Eclipsed by Fat-loss Drugs

Tchang suggested that future anti-obesity medications will actually target fat instead of just weight in general.

Popular semaglutide-based medications, such as Ozempic and Wegovy, were originally developed for managing blood glucose levels among diabetics. They mimic the hormone (GLP-1) released when food is consumed and thereby curb the appetite, slow the passage of food through the digestive tract, and help a person lose weight. Yet the weight loss seen includes both fat and muscle.

Tchang noted that newer drugs, such as Eli Lilly’s bimagrumab, have been showing promise for shedding fat while maintaining muscle mass. She expects more fat-targeting drugs to appear in the future.

Focus Will Shift From Appetite Control to Energy Expenditure

Everyone knows that calories transformed into energy need to be burned off, otherwise, they will likely be stored as fat. Tchang thinks that optimizing energy expenditure will be the new target of researchers given the recent leaps and bounds in controlling appetite.

A key approach here, according to Tchang, is through hormones. Brown fat, which helps maintain the body’s temperature by breaking down glucose and fat to create heat, is already becoming a hot research subject, she said.

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