OBESITY – PATHOPHYSIOLOGY AND MODERN TREATMENT STRATEGIES

Julia Kacperczyk; Julia Bezak; Mateusz Winkler; Aleksandra  Arczewska; Michał Zaborowski; Klaudia Purgał-Zaborowska; Klaudia Michałowska; Oliwier Kolanowski; Olga Turzańska

doi:10.31435/ijitss.2(50).2026.5368

Authors

Julia Kacperczyk Medical University of Lodz, Lodz, Poland https://orcid.org/0009-0007-6354-301X
Julia Bezak Medical University of Lodz, Lodz, Poland https://orcid.org/0009-0005-8598-5594
Mateusz Winkler Nikolaus Copernicus University in Torun, Collegium Medicum, Bydgoszcz, Poland https://orcid.org/0009-0004-4518-4728
Aleksandra Arczewska Medical University of Lodz, Lodz, Poland https://orcid.org/0009-0008-3092-7364
Michał Zaborowski Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0002-7598-3737
Klaudia Purgał-Zaborowska Poznan University of Medical Sciences, Poznan, Poland https://orcid.org/0009-0007-2411-1601
Klaudia Michałowska Nikolaus Copernicus University in Torun, Collegium Medicum, Bydgoszcz, Poland https://orcid.org/0009-0003-7782-2264
Oliwier Kolanowski Nikolaus Copernicus University in Torun, Collegium Medicum, Bydgoszcz, Poland https://orcid.org/0009-0005-0278-1941
Olga Turzańska Jagiellonian University in Krakow, Krakow, Poland https://orcid.org/0009-0007-9495-5834

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5368

Keywords:

Obesity, GLP-1, Semaglutide, Tirzepatide, Retatrutide, Incretins, Obesity Pharmacotherapy

Abstract

Obesity is one of the most significant public health challenges of the 21st century, with its prevalence continuously increasing worldwide. This condition is associated with an elevated risk of numerous metabolic, cardiovascular, and respiratory complications, leading to a substantial burden on healthcare systems. The pathophysiology of obesity is multifactorial and involves complex interactions between genetic, environmental, and neuroendocrine mechanisms regulating energy balance. Gastrointestinal hormones, including leptin, ghrelin, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP), play a crucial role in the regulation of appetite and metabolism.

The aim of this study is to present current knowledge on the pathophysiology of obesity and to review contemporary and emerging treatment strategies. The article discusses classical therapeutic approaches, including lifestyle modification, dietary interventions, increased physical activity, and surgical treatment. Particular attention is given to modern pharmacological therapies targeting the incretin system.

In recent years, significant progress has been made in the pharmacological treatment of obesity with the introduction of GLP-1 receptor agonists, such as semaglutide, as well as dual-acting agents, including tirzepatide, which acts as an agonist of both GLP-1 and GIP receptors. These therapies demonstrate high efficacy in body weight reduction by influencing central mechanisms of appetite regulation, delaying gastric emptying, and improving glucose metabolism. Furthermore, promising directions in obesity treatment are discussed, including triple incretin receptor agonists such as retatrutide, as well as combination therapies utilizing amylin analogues, for example CagriSema.

In conclusion, the development of modern pharmacological therapies is significantly transforming the approach to obesity treatment and may in the future enable outcomes comparable to bariatric surgery. The integration of novel pharmacological methods with comprehensive lifestyle modification may represent the key to more effective management of obesity and reduction of its metabolic and cardiovascular complications.

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