Obesity Phenotypes Explain What Drives the Disease and How to Target Intervention: Expert Interview

Wide variation in response to current treatments for obesity suggest that the disease is really several diseases, with distinct phenotypes unlikely to respond the same way to the same intervention.

Andres Acosta, MD, PhD, and colleagues at the Mayo Clinic describe 4 biological/behavioral obesity phenotypes based on validated measures of body composition, resting energy expenditure, satiety, satiation, affect, and physical activity:

  • Hungry brain — mainly controlled by the brain-gut axis, and abnormal calories needed to reach satiety.
  • Emotional hunger — desire to eat to cope with positive or negative emotions.
  • Hungry gut — abnormal duration of fullness.
  • Slow burn — decreased metabolic rate.

In the conversation with Patient Care® below Acosta details how weight management interventions targeted by phenotype more closely reflect the pathophysiology of the disease.

For more conversations with Dr Acosta:

Andres Acosta, MD, Discusses the Challenge of Heterogeneity in Response to Obesity Treatment

Andres Acosta, MD, is a physician-scientist at Mayo Clinic's campus in Rochester, Minnesota, specializing in bariatric surgery, upper endoscopy, nutrition, and obesity. He is also an assistant professor of medicine at Mayo Clinic College of Medicine and Science. Acosta's primary research focus is on the mechanisms and regulation of appetite, satiation, and satiety, including the role of gastric function, gastrointestinal hormones, taste preferences, bile acids, and enterohepatic regulation and gut energy utilization. Additionally, Dr. Acosta studies the effect of genetics, pharmacology and endoscopic devices on food intake regulation.

Twitter @dr_aac