Reshaping Obesity and Diabetes Care With Innovative Multiagonism Concepts

·27 min·2 clips

Dr. Sue Peterson reveals obesity rates have doubled in adults and quadrupled in adolescents since 1990, affecting 1 in 8 people globally.

The episode is a 35-minute educational presentation by Dr. Sue Peterson, an endocrinologist and clinical lecturer. It begins with an overview of the global obesity epidemic, citing that 1 in 8 people live with obesity and type 2 diabetes prevalence rose from 200 million to 830 million between 1990 and 2022. Obesity is associated with over 200 health conditions across metabolic, mechanical, and mental health domains. The presentation then shifts to the 2025 Obesity Canada Pharmacotherapy Guidelines, which Dr. Peterson led. A key message is to treat obesity early and long-term, not waiting for complications. The guidelines provide a decision tool for selecting medications based on improving specific health conditions. Seven conditions are covered: atherosclerotic cardiovascular disease (recommending semaglutide 2.4 mg weekly), heart failure with preserved ejection fraction, prediabetes, type 2 diabetes, metabolic associated steatohepatitis (MASH), sleep apnea, and osteoarthritis. For each, pharmacotherapy is recommended alongside health behavior change, with BMI thresholds and caveats for other anthropometric measures. The latter part focuses on emerging hormone-based combination therapies. It explains the biology of weight regulation, involving hormones like ghrelin, GLP-1, GIP, amylin, and glucagon. Combination approaches aim for greater weight loss and health benefits. Data is presented from trials like REDEFINE-1 and REDEFINE-2 for CagriSema (a GLP-1/amylin combo), showing weight loss of 20.4% and 13.7% respectively. Other therapies discussed include dual GLP-1/glucagon agonists like mazdutide and cagrilintide, the triple agonist retatrutide (GLP-1/glucagon/GIP), and the unique GLP-1 agonist/GIP antagonist meridadbart-cagrilintide. Side effects are primarily gastrointestinal and mild to moderate. The presentation concludes by emphasizing obesity as a chronic disease and the promise of these novel treatments for improving health outcomes.

As heard by us

Obesity care, from guideline basics to the next wave of hormone-based treatment.

Dr. Sue Peterson presents obesity care as a moving target, beginning with obesity prevalence and obesity-associated health conditions before turning to current recommendations for MASH, sleep apnea, and knee osteoarthritis.

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For the obesity and diabetes update that starts with guidelines and ends in emerging hormone combinations.

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