Precision prevention, diagnostics and treatment of obesity: pipedream or reality?

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.

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

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.”

For more information on the Pennington-Louisiana NORC, visit https://www.pbrc.edu/norc. 

About the Nutrition Obesity Research Center

The NIH-funded research base on which the Pennington-Louisiana NORC was initially established includes basic, clinical and population research addressing the most prominent causes of morbidity and mortality in the United States related to nutritionally induced chronic diseases, many of them linked to obesity. The NORC’s platform includes three scientific Cores: a Bioinformatics & Molecular Mechanisms Core (genomics and cellular; spatial transcriptomics), a Human Phenotyping Core (characterization of phenotypes predisposing to obesity and the metabolic syndrome and behavioral interventions to counteract those) and an Animal Models and Phenotyping Core (Generation of animal models and deep phenotyping of these animals).

The NORC supports clinical investigation addressing the etiology of nutritionally induced chronic diseases across the entire age span, from gestational and perinatal development through childhood and adolescence, to young and middle-aged adults up to elderly individuals.

The NORC brings to the established research base at Pennington and across Louisiana a structured system to provide core services to promote the investigations around our chosen theme of nutrition and metabolic health through the lifespan. The NORC is a mechanism to support the ability of Pennington Biomedical, affiliated universities, and NORC Members to develop cutting edge research focused on the mission of NIDDK.

About the Pennington Biomedical Research Center

The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. Pennington Biomedical has the vision to lead the world in promoting nutrition and metabolic health and eliminating metabolic disease through scientific discoveries that create solutions from cells to society. The center conducts basic, clinical, and population research, and is a campus in the LSU System.

The research enterprise at Pennington Biomedical includes over 600 employees within a network of 44 clinics and research laboratories, and 16 highly specialized core service facilities. Its scientists and physician/scientists are supported by research trainees, lab technicians, nurses, dietitians, and other support personnel. Pennington Biomedical is a globally recognized state-of-the-art research institution in Baton Rouge, Louisiana.

For more information, see www.pbrc.edu.