Marc Schneeberger: «Ozempic-type anti-obesity drugs also have a rebound effect, they are not the solution»

2024-03-28 03:29:05
Marc Schneeberger Pané leads a research group at Yale University (USA) to treat and prevent obesity. His work attempts to describe how the nervous system controls energy balance and metabolism, communicating with multiple peripheral tissues. His research focuses on better understanding how the brain controls energy metabolism, something essential to be able to pharmacologically address this disease. In 2023 he received the Princess of Girona Scientific Research Award. He recently gave a lecture at the National Cardiovascular Research Center (CNIC). -When he was younger he considered the possibility of being a physicist or astrophysicist. And now he is dedicated to obesity. -Since I was little I have been aware of the importance of diet and food. This led me to become interested in how the brain works, how the sensations of eating are regulated and how they stop eating. We have many sensations associated with eating, such as pleasure or anger. When a person hasn’t eaten for hours, he has the feeling of inhibiting himself in conversations and social situations in order to eat. Eating, drinking, sleeping are the most animal instincts we have. There are certain vital processes inherent to human beings as animals, from babies who cry non-stop because they don’t have food to adults. Related News standard No Spanish women resist the obesity pandemic Rafael Ibarra The latest WHO report observes a slight decrease in female obesity, with 7% recorded in 1990 compared to 4% in 2022 -Is it the fault of Is obesity in the brain? -In the end, the deregulated process that leads us to obesity is nothing more than an increase in the intake of foods rich in fat and sugar. Today we are surrounded by these foods, which generate addiction due to their high nutritional power for the brain. For our brain, having energy stores is beneficial; It allows us to go several days without eating and thus survive. Evolutionarily we are not that far from those times when there was no food permanently available to man. -There are more and more effective treatments for obesity, but the number of people with weight problems continues to grow. -On the one hand, we have realized that funding is largely intended to treat obesity, not prevent it. We are almost at pandemic levels and it is estimated that 40% of the population will be obese. And we must not forget that this is a very large pharmacological market. This means that private financing from the pharmaceutical industry is aimed at finding solutions to reduce weight or maintain chronically low weight. In my opinion, if we talk about prevention, what should be done is to encourage educational actions by governments. In this way, society will be able to incorporate the message that eating healthy is beneficial both for the brain development of our body and for our health in general. In the end, by being constantly exposed to these diets rich in sugars and fats, what favors, apart from all the associated diseases, is that we generate addictions to foods that are not nutritious and that cause inflammation. The consequences associated with not having adequate nutritional habits are very harmful in many aspects: socioeconomic and health. We are almost at pandemic levels and it is estimated that 40% of the population will be obese – It is said that an obese child will be an obese adult with health problems. It’s right? The correlation is direct. Being exposed to this type of diet from a young age and during adolescence predisposes the body. The clearest example is the addiction to drinks rich in sugar: when we drink a sugary soft drink for a couple of days we have the feeling that we need that soft drink every day. And the same happens with other products rich in sugars and fats. They are pleasurable products that the brain detects have high nutritional power, so if we can choose a food, our brain will make us choose that type of food. At the level of prevention, there are messages that were in our society that are common sense and it is not that difficult to become aware of them. I remember the concept ‘have breakfast like a king, lunch like a prince and dinner like a poor man’. This saying has a biological meaning because, when we are most active, we need more nutrients because of what we burn, while, at bedtime, when our metabolism stops, we have to have a copious dinner, which is a trend. very common, it is a mistake. I believe that the majority of the population is capable of dedicating half an hour a day to thinking and changing those habits. By this I do not mean that you have to dedicate an hour to breakfast, half an hour to lunch, etc. The authorities have to understand that for prevention they must act on both sides: doing physical exercise is good, but it has to be accompanied by a balanced diet -How is Spain doing on this issue? -Until a few years ago, obesity numbers were relatively low. But the situation has changed a lot. For example, in areas like the Canary Islands it is estimated that there is 40% childhood obesity, and in many autonomous communities the rate is 20% or 30%. That is, we have numbers very similar to those of the US, where they are around 40%. The authorities have to understand that for prevention they must act on both sides: doing physical exercise is good, but it has to be accompanied by a balanced diet. -How can you educate the brain to select the healthiest foods? -For that same reason, nutrition education must be emphasized with programs from a young age, both in schools and at home. We have to be aware of the relevance of nutrition because what the brain does, through the hedonic circuit, the same circuit that is activated when drugs of abuse such as cocaine are consumed, is cause an increase in dopamine signaling, a neurotransmitter. that generates that pleasant feeling. If a person manages to satisfy that nutritional need with other types of healthy foods, the brain, when it receives enough nutrients, and is educated, is capable of making us follow a balanced diet. It will not predispose us to consume foods rich in fats or sugars. -Do taxes on these foods work? -The taxes that were imposed on sugar have not changed anything. There is a controversy about not investing in prevention, but investing in treatments. The message that society wants, at a certain level, is that I can eat what I want because it is pleasurable, but without it leading to an increase in my weight. That is the aesthetic part associated with obesity that one does not want to live with. Many times we are not aware of the impact that we can have if we are exposed to diets rich in fats and sugars on our body, even if we maintain our body weight. This high-fat diet means that we are in a constant situation of inflammation, of inflammatory markers that are circulating. This inflammation is still present, even if our weight is stable. And that involves brain inflammation, developmental problems, cancer. That is to say, there are a lot of diseases associated with obesity that could be prevented. Now, with this I do not mean that there is no need to investigate treatments, since we must treat the 40% of the population that already has obesity. But it is especially important to be aware that where we can have a real and most effective impact is in prevention so that future generations do not reach these obesity numbers and that, progressively, we live in a healthier society. -GLP1 inhibitors -Wegovy, Ozempic, Rybelsus and Saxenda- have become fashionable drugs. Are they the solution? -The problem is that, at a chronic level, I don’t know if we will be able to maintain the weight. For our body, for our brain, if the hunger circuit is deregulated and the brain understands that our body weight has to be above it, the moment we stop the treatment, we will gain weight again. The rebound effect also exists with these medications. But, also, financially not everyone can afford these treatments. We cannot trust the State to finance these medications for 40% of the population; It seems reckless. Therefore, at the government level, it is still more effective to work on prevention. On a scientific level, what we can do is contribute to demonstrating the impact that diets have on our brain development. Related News standard No Microplastics accumulate in more than half of clogged arteries R. Ibarra People in whom plastic fragments were detected had a higher risk of suffering a combination of myocardial infarction, stroke or death from any cause at 34 months Our research now focuses on the study of childhood obesity in animal models. We want to try to make a homology of childhood obesity in animal models to see what consequences obesity has at the level of metabolism, neuronal functioning, what areas of the brain are more sensitive to certain types of diets, what consequences it can have for a mother while she is pregnant is obese on her future offspring, etc. The objective is to understand what happens to a person exposed to obesity during their development, whether during childhood or adolescence, even if they later do physical exercise programs and regain their healthy weight. We also want to know what will happen when you stop doing that intense physical exercise. Is there a memory to that body weight? -We are what we eat? -These types of traditional phrases that we have heard many times are true. We do not know the effects of processed foods rich in chemicals and additives intended to preserve products long term. What is clear is that there is an exponential increase in a lot of diseases related to obesity, such as cardiovascular disease, cancer, Alzheimer’s, etc.
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