Weight loss: the latest innovative tracks
The population of overweight people is becoming increasingly heavy in the world. A plague such as many scientific teams are mobilizing to find new therapeutic routes. And they move forward.
Obesity - which corresponds to a higher body mass index (BMI) at 30 - and overweight (BMI greater than 25) are true global epidemics. According to figures provided by WHO, there are hundreds of millions of people around the world. France is not immune to this phenomenon since a study published in 2016 showed that one inhabitant of the Hexagon out of two is too big (56.8% of men and 40.9% of women). This has a considerable impact in terms of public health: increased occurrence of cardiovascular diseases, impact on the emergence of type 2 diabetes and cancers, infertility and osteo-articular disorders. Faced with this worrying rise, current medicine is striving to find alternative solutions to surgery (gastric banding, sleeve gastrectomy, bypass) that works well but does not go without inconvenience or complications.
If these pockets containing air or a saline solution that is introduced into the stomach have existed for twenty years, a new variation, Elipse ™ received a marketing authorization in December 2015. Unlike those that were previously available, this balloon does not require operation, anesthesia or endoscopy, neither during the pose, nor for the removal. It goes through a capsule, unfolds in the stomach and fills with a catheter that goes from the mouth to the stomach. It stays in place for sixteen weeks before the thin membrane covering it pierces. It eliminates naturally when one goes to the saddle. Its action, which must be correlated with a rebalancing of food and the practice of physical exercise, is twofold. On the one hand, it stimulates the baroreceptors of the stomach that inform the brain about the state of satiety, on the other, it slows down the gastric emptying and makes so that we perceive less the sensation of hunger. "His main indication is patients who have a BMI equal to or greater than 27 and who need to lose ten to fifteen pounds. But used in super-obese, who have a BMI above 50, it causes a weight loss that can make them eligible for anesthesia and therefore surgery that they had not previously accessed, especially because of the difficulty to ventilate them during this one, "says Dr. Sophie Al Samman-Zouaghi.
Digestive hormones at the heart of research
Many scientific protocols aim to find a way to control digestive hormones. This is on the one hand to stimulate leptin. The latter, which is poorly or poorly secreted in overweight individuals, targets neurons at the level of the hypothalamus to transmit the signal of "suppression" of appetite. And on the other hand to lower the level of ghrelin, substance that increases the impression of hunger. If the first tests on humans have not been conclusive and if we are still at the beginning of discoveries in this field, we can imagine that we will have in the future drugs or gene therapies that will regulate this hormonal tandem. "We must hope that their use will remain highly regulated," says our specialist, who fears the excesses that could cause such a feat.
Stimulation of brown adipocytes
There are two types of cells in our body devoted to storing fats, white adipocytes (which store them) and brown adipocytes (which burn them, especially to regulate body temperature). The latter, very present in newborns, declined considerably but did not disappear in adults, for the benefit of their white counterparts who become ultra-majority. The challenge for scientific research is to succeed in promoting them. In 2016, a team from Inserm managed to introduce a gene, Pax3, in "bad" adipocytes in vitro to turn them into "good" adipocytes. Case to follow, since it remains to obtain the same result in vivo ... In Australia, in 2011, Sydney endocrinologists successfully cultivated these same brown adipocytes, extracted from the stem cells of six patients, before injecting them. Applied on a larger scale, these techniques could be powerful weapons in the fight against obesity and overweight.
The intestinal flora transplant
Since the triumph of Giula Enders' discreet charm of the intestine, no one is unaware of the impact that the bacterial microbiota - "universe" that resides in our intestines and which has up to ten times more microorganisms than we have. of cells - a on our general health. However, it turns out that if obesity is correlated with a genetic predisposition, poor eating habits and sedentary lifestyle, it is also linked to a degradation of this flora. An experiment conducted at the University of St. Louis in the United States on mice has shown that animals that were implanted with feces of obese people were growing while recipients of thin people kept a stable weight. It is thus very possible to transpose this process to the human soon, as is already done for the treatment of IBD (inflammatory bowel disease). "Exploring the microbiota is fundamental. If there is a drug that comes out against obesity, it could be that, maybe in the form of bacteria capsules to ingest ... I think that will change our medicine in this area and others, even if we must not give in to the fashion effect, "says Sophie Al Samman-Zouaghi.
The hope of a "sport-like" molecule
And if we conceived a product that would have the same effects on our body as physical exercise? This is precisely what a group of researchers from the University of Southampton, in the United Kingdom, has achieved. Called "Compound 14", this molecule aims to lure metabolic cells into believing that they are running out of energy, which increases the burning of calories. Effective on rodents, it could allow long-term, again, the development of a drug against obesity, overweight and diabetes. "But nothing can completely imitate the virtuous effects of" true "sport, especially on the psyche, says our specialist. It is certain that medicine can meet this challenge but I hope that it will not be prescribed without the necessary ethical precautions. In the meantime, overweight or not, do not forbid yourself to jump in your sneakers to burn some calories.
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