Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women

ObjectiveAs there is significant heterogeneity in the weight loss response to pharmacotherapy, one of the most important clinical questions in obesity medicine is how to predict an individual’s response to pharmacotherapy. The present study examines patterns of weight loss among overweight and obese...

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Autores principales:	Megan Rodgers, Alexandra L. Migdal, Tahereh Ghorbani Rodríguez, Zsu-Zsu Chen, Anjali K. Nath, Robert E. Gerszten, Natasha Kasid, Elena Toschi, Juliet Tripaldi, Brent Heineman, Minh Phan, Long Ngo, Eleftheria Maratos-Flier, Jody Dushay
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	overweight obesity weight loss exenatide hypocaloric diet Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/0701fa9ada194f24bff97b3608c895cb
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spelling	oai:doaj.org-article:0701fa9ada194f24bff97b3608c895cb2021-11-17T06:40:16ZWeight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women1664-239210.3389/fendo.2021.742873https://doaj.org/article/0701fa9ada194f24bff97b3608c895cb2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.742873/fullhttps://doaj.org/toc/1664-2392ObjectiveAs there is significant heterogeneity in the weight loss response to pharmacotherapy, one of the most important clinical questions in obesity medicine is how to predict an individual’s response to pharmacotherapy. The present study examines patterns of weight loss among overweight and obese women who demonstrated early robust response to twice daily exenatide treatment compared to those treated with hypocaloric diet and matched placebo injections.MethodsWe randomized 182 women (BMI 25-48 kg/m2) to treatment with exenatide alone or matched placebo injections plus hypocaloric diet. In both treatment groups, women who demonstrated ≥ 5% weight loss at 12 weeks were characterized as high responders and those who lost ≥10% of body weight were classified as super responders. Our primary outcome was long-term change in body weight among early high responders to either treatment. An exploratory metabolomic analysis was also performed.ResultsWe observed individual variability in weight loss with both exenatide and hypocaloric diet plus placebo injections. There was a trend toward a higher percentage of subjects who achieved ≥ 5% weight loss with exenatide compared to diet (56% of those treated with exenatide, 76% of those treated with diet, p = 0.05) but no significant difference in those who achieved ≥ 10% weight loss (23% of individuals treated with exenatide and 36% of those treated with diet, p = 0.55). In both treatment groups, higher weight loss at 3 months of treatment predicted super responder status (diet p=0.0098, exenatide p=0.0080). Both treatment groups also demonstrated similar peak weight loss during the study period. We observed lower cysteine concentrations in the exenatide responder group (0.81 vs 0.48 p < 0.0001) and a trend toward higher levels of serotonin, aminoisobutyric acid, anandamide, and sarcosine in the exenatide super responder group.ConclusionIn a population of early high responders, longer term weight loss with exenatide treatment is similar to that achieved with a hypocaloric diet.Clinical Trial Registrationwww.clinicaltrialsgov, identifier NCT01590433.Megan RodgersAlexandra L. MigdalTahereh Ghorbani RodríguezZsu-Zsu ChenAnjali K. NathRobert E. GersztenNatasha KasidElena ToschiJuliet TripaldiBrent HeinemanMinh PhanLong NgoEleftheria Maratos-FlierJody DushayFrontiers Media S.A.articleoverweightobesityweight lossexenatidehypocaloric dietDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	overweight obesity weight loss exenatide hypocaloric diet Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	overweight obesity weight loss exenatide hypocaloric diet Diseases of the endocrine glands. Clinical endocrinology RC648-665 Megan Rodgers Alexandra L. Migdal Tahereh Ghorbani Rodríguez Zsu-Zsu Chen Anjali K. Nath Robert E. Gerszten Natasha Kasid Elena Toschi Juliet Tripaldi Brent Heineman Minh Phan Long Ngo Eleftheria Maratos-Flier Jody Dushay Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women
description	ObjectiveAs there is significant heterogeneity in the weight loss response to pharmacotherapy, one of the most important clinical questions in obesity medicine is how to predict an individual’s response to pharmacotherapy. The present study examines patterns of weight loss among overweight and obese women who demonstrated early robust response to twice daily exenatide treatment compared to those treated with hypocaloric diet and matched placebo injections.MethodsWe randomized 182 women (BMI 25-48 kg/m2) to treatment with exenatide alone or matched placebo injections plus hypocaloric diet. In both treatment groups, women who demonstrated ≥ 5% weight loss at 12 weeks were characterized as high responders and those who lost ≥10% of body weight were classified as super responders. Our primary outcome was long-term change in body weight among early high responders to either treatment. An exploratory metabolomic analysis was also performed.ResultsWe observed individual variability in weight loss with both exenatide and hypocaloric diet plus placebo injections. There was a trend toward a higher percentage of subjects who achieved ≥ 5% weight loss with exenatide compared to diet (56% of those treated with exenatide, 76% of those treated with diet, p = 0.05) but no significant difference in those who achieved ≥ 10% weight loss (23% of individuals treated with exenatide and 36% of those treated with diet, p = 0.55). In both treatment groups, higher weight loss at 3 months of treatment predicted super responder status (diet p=0.0098, exenatide p=0.0080). Both treatment groups also demonstrated similar peak weight loss during the study period. We observed lower cysteine concentrations in the exenatide responder group (0.81 vs 0.48 p < 0.0001) and a trend toward higher levels of serotonin, aminoisobutyric acid, anandamide, and sarcosine in the exenatide super responder group.ConclusionIn a population of early high responders, longer term weight loss with exenatide treatment is similar to that achieved with a hypocaloric diet.Clinical Trial Registrationwww.clinicaltrialsgov, identifier NCT01590433.
format	article
author	Megan Rodgers Alexandra L. Migdal Tahereh Ghorbani Rodríguez Zsu-Zsu Chen Anjali K. Nath Robert E. Gerszten Natasha Kasid Elena Toschi Juliet Tripaldi Brent Heineman Minh Phan Long Ngo Eleftheria Maratos-Flier Jody Dushay
author_facet	Megan Rodgers Alexandra L. Migdal Tahereh Ghorbani Rodríguez Zsu-Zsu Chen Anjali K. Nath Robert E. Gerszten Natasha Kasid Elena Toschi Juliet Tripaldi Brent Heineman Minh Phan Long Ngo Eleftheria Maratos-Flier Jody Dushay
author_sort	Megan Rodgers
title	Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women
title_short	Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women
title_full	Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women
title_fullStr	Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women
title_full_unstemmed	Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women
title_sort	weight loss outcomes among early high responders to exenatide treatment: a randomized, placebo controlled study in overweight and obese women
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/0701fa9ada194f24bff97b3608c895cb
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Weight Loss Outcomes Among Early High Responders to Exenatide Treatment: A Randomized, Placebo Controlled Study in Overweight and Obese Women

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