Overview of available treatment and new drug action points in obesity pharmacology. Will GIP, glucagon, amylin replace GLP-1?

Nearly 50% of the world's population struggles with excess body weight. Elevated BMI contributed to about 5 million deaths from non-communicable diseases in 2019 and is a defined negative predictor of numerous diseases, mainly on the cardiovascular side. The purpose of this article is to characterize possible new drug breakthrough points for obesity therapy and also to describe already available approaches. Pubmed and clinical trials databes was searched using obesity, GLP-1, GIP, glucagon, amylin as the key words. To date, five drugs have been registered in the European Union for the treatment of obesity. Of these, Glucagon-like peptide-1 agonists administered by subcutaneous injection are the most effective. In order to further increase the effectiveness of overweight therapy, research is underway to combine different mechanisms of action in a single preparation. Promising directions are substances that activate receptors for glucagon and amylin, which may represent new points of action in the treatment of obesity. A preparation combining agonism of glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide and glucagon receptors - retatrutide - showed a significant weight reduction effect of 24% over 48 weeks. However, further studies including comparative analyses are needed to reliably assess their efficacy and safety.