New Frontiers in Nutritional and Therapeutic Interventions for Obesity Phenotypes
Angelo Maria Patti,
Rosaria Vincenza Giglio,
Marcello Ciaccio,
Anca Pantea Stoian,
Teodor Salmen,
Ioana-Cristina Bica,
Imran Rangraze,
Mohamed El Tanani,
Manfredi Rizzo,
Ali Abbas Rizvi
Affiliations
Angelo Maria Patti
Internal Medicine Unit, “Vittorio Emanuele II” Hospital, 91022 Castelvetrano, Italy
Rosaria Vincenza Giglio
Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90133 Palermo, Italy
Marcello Ciaccio
Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, 90133 Palermo, Italy
Anca Pantea Stoian
Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
Teodor Salmen
Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
Ioana-Cristina Bica
Doctoral School, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
Imran Rangraze
Internal Medicine Department, College of Medical Sciences, Ras Al Khaimah Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah 11172, United Arab Emirates
Mohamed El Tanani
Internal Medicine Department, College of Medical Sciences, Ras Al Khaimah Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah 11172, United Arab Emirates
Manfredi Rizzo
Internal Medicine Department, College of Medical Sciences, Ras Al Khaimah Medical & Health Sciences University (RAKMHSU), Ras Al Khaimah 11172, United Arab Emirates
Ali Abbas Rizvi
Department of Medicine, Division of Endocrinology, Orlando VA Medical Center and University of Central Florida College of Medicine, Orlando, FL 32827, USA
The heterogeneity among patients with obesity is particularly evident in the weight loss response to interventions such as diets, drugs, devices and surgery. Obesity can be “catalogued” into four phenotypes: hungry brain (abnormal satiety for alteration of gut–brain axis), emotional hunger (hedonic eating), hungry gut (abnormal duration of satiety for faster gastric emptying) and slow burning (slowing of the metabolic rate). Phenotypes are grafted onto this complexity, the recognition of which allows for personalized medicine and increasingly targeted therapies. Although there are no standardized treatment protocols, we present management options consisting of lifestyle modifications and pharmacologic therapies. Nutritional advice and encouragement of adequate physical activity lead to increased self-efficacy and promote a sense of well-being when coupled with psychological approaches involving mindful eating. In summary, obesity has a complex pathophysiology best addressed through a therapeutic process suited to the phenotype encountered and in synergy with multifactorial interventions.
