Advancing precision medicine to transform obesity prevention and treatment

A new report led by researchers at Pennington Biomedical Research Center underscores the growing potential of precision medicine to transform how obesity is prevented, diagnosed and treated, while also illuminating key gaps and challenges that must be addressed.

Published in September in Obesity, the paper, "Precision Prevention, Diagnostics and Treatment of Obesity," synthesizes the proceedings of a recent Pennington-Louisiana Nutrition Obesity Research Center, or NORC, scientific workshop that was convened to review current evidence on tailoring obesity interventions to individual biology, environment, behavior and social factors.

Key findings

• Multifactorial precision: Obesity is not a one-size-fits-all condition. The authors emphasize how numerous factors – genetics, epigenetics, metabolic phenotypes, microbiome characteristics and environmental exposures – interact to influence individual differences in weight gain, weight loss and response to therapy.
• Diagnostics innovation: Improved diagnostic tools – for example, biomarkers and imaging – are critical for accurately classifying obesity subtypes and risk, which in turn can guide more personalized prevention and treatment.
• Treatment personalization: The review highlights emerging data that suggests modifying diet, exercise, pharmacotherapy and behavioral interventions to individual risk profiles may produce more effective and sustainable outcomes. More research is needed to solidify best practices.
• Gaps and barriers: Despite enthusiasm, significant obstacles remain, including limited large-scale clinical trials of precision strategies, lack of diversity in study populations, underdeveloped cost-effectiveness data, and challenges in integrating precision tools into routine clinical settings.

The authors suggest that precision-based approaches to obesity could improve prevention of the disease by identifying individuals at high risk earlier and tailoring lifestyle or environmental interventions accordingly. In addition, precision-based approaches may enhance treatment outcomes. Customizing therapeutic approaches to a person's biological and behavioral profile has potential to reduce side effects and inefficiencies by avoiding trial-and-error in pharmacological or surgical interventions.

The authors emphasize that precision obesity medicine is still in its early stages, and findings should be carefully evaluated before translation into clinical practice until stronger evidence supports specific personalized approaches.

Despite tremendous interest in precision-based treatment, the field is still relatively young. We need rigorous clinical trials to empirically determine if precision treatment is indeed better than current practices. Unfortunately, few such trials exist, and those that do are not always supportive."

Dr. Corby Martin, Co-Chair of the symposium and Director of the NORC Human Phenotyping Core

To move the field forward, the authors recommend more diverse and inclusive clinical research to ensure findings generalize across populations; development and validation of robust biomarkers, imaging, and diagnostic tools; comparative effectiveness trials that assess how precision-based interventions stack up to standard approaches; and programs and policies to support affordable access to precision obesity care.

For the past 25 years the Pennington-Louisiana NORC has supported the assembly of more than 100 scientists per year around emerging topics in obesity and nutrition research.

"Supporting 1.5 day workshops such as the 'Precision Prevention, Diagnostics, and Treatment of Obesity' brings top scientists and clinicians from around the world to Pennington Biomedical, and these reports provide a blueprint for the current state of the science and avenues for future research," said NORC Director Dr. Leanne Redman, LPFA Endowed Chair in Nutrition and Associate Executive Director for Scientific Education.

The NORC scientific workshop "Precision Prevention, Diagnostics and Treatment of Obesity: Pipedream or Reality?" was held April 15-16, 2024.

"This team's efforts in advancing precision medicine to diagnose, prevent and treat obesity are truly commendable," Pennington Biomedical Executive Director Dr. John Kirwan said. "At Pennington Biomedical, our work is built on strong partnerships across Louisiana and throughout the United States, strengthened through centers and institutes like the Pennington-Louisiana NORC. We are proud to collaborate with leading research institutions, universities, and healthcare systems nationwide to advance obesity research."