Can a Saliva Test Predict the Best Way to Manage Obesity?

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May 23, 2023 – It sounds for illustration a elemental solution to a analyzable problem: Find retired what kind of obesity you person based connected a one-time familial saliva test. Then you and your expert tin get a amended thought if anti-obesity narcotics aliases different treatments are much apt to activity for you.  

The extremity of creating nan obesity types and trial is to summation chances you’ll suffer weight and amended your wellness and well-being, vs. a one-strategy-fits-all approach. It’s what Mayo Clinic researchers had successful mind erstwhile they created 4 phenotypes of obesity. 

Obesity experts not affiliated pinch nan investigation person immoderate concerns and opportunity independent studies are needed to verify nan imaginable of this strategy.

This investigation could thief foretell who will respond champion to celebrated anti-obesity medications, said Andres Acosta, MD, PhD, co-founder of Phenomix Sciences, nan institution down nan tests. These medications see nan people of narcotics called glucagon-like peptide receptor agonists (GLP-1s) for illustration liraglutide (Saxenda, Victoza) and semaglutide (Ozempic, Wegovy).

“We cognize that not everyone connected a GLP-1 will respond. In reality, astir a 3rd of nan patients don't do good pinch GLP-1s,” said Acosta, an adjunct professor of medicine and interrogator successful nan Division of Gastroenterology and Hepatology astatine nan Mayo Clinic successful Rochester, MN. 

Furthest on successful improvement is nan “My Phenome Hungry Gut” trial for predicting GLP-1 response. People successful this Hungry Gut group thin to quiet their tummy aft a repast faster and are much apt to consciousness quiet again a short clip later, arsenic explained connected the company’s website

A aviator study to trial really good it useful started successful April astatine 3 superior attraction practices. Plans are to grow real-world testing for this and different obesity types later this year. 

The different obesity categories are:

  • "Hungry Brain," wherever nan encephalon does not admit signals that nan tummy is full
  • "Emotional Hunger," wherever cravings to eat are driven by emotions, anxiety, and antagonistic feelings
  • "Slow Burn," wherever group person a slow metabolism and debased power level

People successful these categories mightiness beryllium much apt to use from different obesity guidance strategies, for illustration changes to their fare aliases placement of an intragastric balloon.

Some Things to Consider

While applauding their efforts to beryllium much precise successful treating group pinch obesity, not each experts are convinced this saliva trial will beryllium nan answer. The company’s investigation mightiness look promising, but verification of results is warranted. 

“Can we get amended outcomes pinch things for illustration this? Well, that's nan hope,” said Jaime Almandoz, MD, aesculapian head of Weight Wellness astatine nan University of Texas Southwestern Medical Center successful Dallas.

“We still don't person randomized tests wherever we're looking astatine obesity phenotyping yet,” said Almandoz, who is besides a spokesperson for The Obesity Society, a master group of clinicians, researchers, educators, and others focused connected obesity science, treatment, and prevention.

There is ever interest erstwhile a diagnostic trial is being developed for commercialized use, said Daniel Bessesen, MD, a professor of medicine-endocrinology, metabolism, and glucosuria astatine nan University of Colorado School of Medicine successful Denver. “What they're talking astir doing is ace important. But this is simply a company. This is simply a institution that is, I think, trading a product.”

In an online search, Bessesen did not find immoderate outer studies that showed really good nan saliva testing worked. But referring to activity by Acosta and Michael Camilleri, MD, nan different co-founder of Phenomix, he said, “I recovered immoderate papers that they did that I hadn't publication earlier that are good.”

“These guys are smart guys. And they've done a batch of activity connected [the activity of nutrient done nan gut] and really that correlates pinch obesity and consequence to immoderate therapies,” said Bessesen, who is besides a spokesperson for The Obesity Society. “So their technological activity does statement up pinch this area.”

Validation of immoderate investigation is important because nan obesity manufacture has been known for a batch of lose-weight-quick strategies, immoderate pinch small aliases nary subject down them, he said. 

It is besides essential, he said, because “anytime you do thing commercialized successful nan area of obesity, you person to admit that group pinch obesity are a susceptible population. These group look stigma and bias each nan time.”

Removing nan Stigma

If knowing your obesity type ends up making a difference, it could alteration nan speech group person pinch their aesculapian provider, Acosta said. It could besides thief region immoderate of nan stigma astir obesity.

“We're going to alteration nan speech because now we tin say, ‘Hey, you person obesity because you person 'Hungry Gut’ phenotype. And because of that, you're going to respond to this medication,” Acosta said. The phenotyping suggests a beardown familial inclination – a biologic ground for obesity. 

“So it’s not only a measurement of taking nan blasted out, but it's besides measurement of explaining that there's a logic why you person obesity,” Acosta said. It tells people: “You're not a failure.”

More Cost-Effective Treatment?

Targeting obesity curen could besides prevention connected wide wellness attraction costs, Almandoz said. He estimated a costs of $1,400 per period “for everlastingly and ever semaglutide” aliases astatine slightest $1,400 a period for a 3-month proceedings to spot if this medicine useful successful a peculiar personification pinch obesity.

“That's a batch of money erstwhile you extrapolate that retired complete nan number of group who astir apt meet nan criteria for treatment,” he said. A full 42% of Americans meet the CDC meaning for obesity. 

“You tin ideate nan imaginable costs if we were to supply anti-obesity therapies to everybody and we were to usage what is nan astir effective people of medication, which is much than a 1000 dollars per month, indefinitely,” Almandoz said. “Not that we should not dainty everybody. That's not nan connection I’m saying. But if we're looking astatine output aliases worth successful position of treating obesity successful a mounting pinch constricted resources, it whitethorn beryllium champion to commencement pinch who is astir apt to benefit.” 

How They Created Four Obesity Types

Starting successful 2015, Acosta and colleagues started comparing tests successful group pinch normal weight vs. obesity. They utilized artificial intelligence and instrumentality learning to categorize obesity into 11 types astatine first. They realized this galore obesity types were not applicable for doctors and group pinch obesity, truthful they mixed them into 4 phenotypes. 

“The AI instrumentality learning was followed by, arsenic I for illustration to call, H.I., aliases quality intelligence,” he said. 

The saliva trial checks for astir 6,000 relevant genetic SNPs. SNPs are “single nucleotide polymorphisms,” aliases changes successful genes. Six 1000 familial changes whitethorn sound for illustration a ample number to cheque until you study that group locomotion astir pinch betwixt 5 cardinal and 6 cardinal SNPs successful their DNA. 

The results are translated to a people that yields a debased consequence aliases precocious consequence for Hungry Gut aliases different types of obesity. “You tin person each six 1000 familial mutations, aliases you tin person zero,” Acosta said.

Moving Forward

After nan soft motorboat of Hungry Gut testing successful April, Phenomix plans to proceed studying their saliva trial connected different obesity types.  

Acosta is not alert of immoderate nonstop competitors to Phenomix, though that could change. “I deliberation we're nan only diagnostic institution successful nan abstraction correct now. But if it's really a $14.8 cardinal market, we're going to spot a batch of diagnostic companies trying to do what we're doing – if we’re successful,” he said. 

An October 2022 report from Polaris Market Research estimates that nan world marketplace for obesity curen – medications, surgery, and each others – was astir $14 cardinal successful 2021. The aforesaid study predicts nan marketplace will turn to $32 cardinal by 2030. 

Source Health