[hi-v-rocknroll]

The act of losing weight necessitates reduction of the mass of triglyceride stored in fat cells, so this sounds like a "duh", but whether it accelerates it through activating beneficial pathways is another matter. (E.g., how similar is a GLP-1 agonist to say diet alone or diet+exercise?)

There are many GLP-1 agonists approved now. Some are approved for type-2 diabetes as one trade name, and may also be approved under another trade name at a higher dosage. For example, Lixisenatide came off-patent for diabetes in 2020 but it doesn't have an obesity formulation in the US. The various GLP-1 agonists have slightly different risk profiles of causing pancreatitis and/or thyroid cancers.

I don't know though maybe the freezing method (cryolipolysis) could potentially be useful for some people, but it's probably still too soon to characterize its long-term risks and other benefits.

Also, CagriSema (cagrilintide (long-acting amylin analogue) & semaglutide) is promising for obesity.

[nradov]

I think cryolipolysis can only reduce subcutaneous fat, not visceral fat.

[hi-v-rocknroll]

There's really no good mechanical way to preferentially kill adipose visceral cells to prevent them from storing excess energy in the first place. It's mostly a cosmetic procedure to reduce subcutaneous adipose population with fewer risks than mechanical surgery, but I bet it has very slight benefits but not enough to equal clinical management of obesity.

Maybe in the future there will be a temporary immunotherapy target to get the immune system to attack adipose cells but then terminate/unlearn before it gets too carried away.

[carlmr]

>Maybe in the future there will be a temporary immunotherapy target to get the immune system to attack adipose cells but then terminate/unlearn before it gets too carried away.

Unlearning is usually not a thing for our immune system. I don't think this would even be the most promising target. Imagine being able to reverse autoimmune disorders.

[hi-v-rocknroll]

> Imagine being able to reverse autoimmune disorders

That would be awesome. Perhaps if it were possible dump the state of memory B cells (I'm wondering if flow cytometry can do this), classify and inventory immunoglobulins, filter them out via perfusion, and custom program naive B cells and add them back to the body. Memory T cell types seem way messier but some should be tunable with epigenetic levers. We will eventually learn how to hack the adaptive immune system, but it's going to take a lot of research time and effort to produce to a specific autoimmune therapy for a specific clinical problem likely customized to a single individual.