Management of Monogenic and Syndromic Obesity

Gastroenterol Clin North Am. 2023 Dec;52(4):733-750. doi: 10.1016/j.gtc.2023.08.005. Epub 2023 Sep 27.

Abstract

Similar to the general population, lifestyle interventions focused on nutrition and physical activity form the foundation for treating obesity caused by rare genetic disorders. Additional therapies, including metreleptin and setmelanotide, that target defects within the leptin signaling pathway can effectively synergize with lifestyle efforts to treat monogenic disorders of leptin, leptin receptor, proopiomelanocortin (POMC), and proprotein convertase subtilisin/kexin type 1 (PCSK1) and syndromic conditions, such as the ciliopathies Bardet-Biedl and Alström syndromes, whose pathophysiological mechanisms also converge on the leptin pathway. Investigational treatments for Prader-Willi syndrome target specific defects caused by reduced expression of paternally derived genes within the chromosome 15q region.

Keywords: Bardet-Biedl syndrome; Ciliopathy; Leptin; Metreleptin; Monogenic obesity; Prader-Willi syndrome; Proopiomelanocortin; Setmelanotide; Syndromic obesity.

Publication types

  • Review

MeSH terms

  • Humans
  • Leptin* / genetics
  • Obesity / genetics
  • Obesity / metabolism
  • Obesity / therapy
  • Prader-Willi Syndrome* / genetics
  • Prader-Willi Syndrome* / therapy

Substances

  • Leptin