WHILE WE TRY TO DISPOSE OF THE ADIPOSE

Studies show that many of the medicines that help cut flab may trigger side effects like gastrointestinal trouble, heightened anxiety and skeletal muscle loss. They must be used with extreme care

- K SRINATH REDDY

As overweight and obesity levels rise in populations the world over, they pose much more than cosmetic and mobility challenges to people. Body fat, especially visceral fat which is stored within the abdomen, is a factory that churns out an army of proand anti-inflammatory chemicals.

As visceral fat deposits rise, they release a flood of tissue-damaging pro-inflammatory chemicals, while reducing the production of anti-inflammatory chemicals like adiponectin. This chronic assault on body tissues increases the risk of cardiovascular diseases, diabetes, cancer and dementia.

Development and clinical deployment of several anti-obesity drugs has recently provided powerful interventions to reduce body weight and confer protection against the cardio-metabolic hazards associated with obesity. After years of limited success in providing effective medical treatments for obesity (beyond invasive surgical treatments), these drugs demonstrated dramatic results. A booming global market has emerged over the past few years, with clamour for these ‘miracle drugs’ going beyond clinical use to cosmetic transformation.

This was made possible by pathbreaking advances in biomedical research which helped to identify many hormones that are produced naturally by the body to regulate appetite, gastric motility and blood glucose levels, with brain signalling acting as a powerful communication tool to coordinate physiologic functions across a complex web of neuro-endocrine and metabolic pathways.

Among these, recently-discovered glucagon-like peptide (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) have emerged as key players besides well recognised hormones like insulin and glucagon. GLP-1 is a natural hormone produced mainly by the L-cells of the ileum (lower part of the small intestine). GIP, also known as gastric inhibitory polypeptide, is produced by the K-cells of the jejunum (upper part of the small intestine).