FROM MOLECULAR MECHANISMS TO INNOVATIVE THERAPIES: A COMPREHENSIVE REVIEW OF CONTEMPORARY APPROACHES TO OBESITY

Obesity is a chronic, multifactorial disease resulting from complex interactions between genetic predisposition, environmental influences, lifestyle factors, and the gut microbiota. The objective of this review is to provide a concise summary of the current evidence on the molecular and epigenetic mechanisms that underpin obesity, the role of the gut microbiota, and the emerging therapeutic strategies that are available. The reviewed data indicate that numerous genetic variants, including those in the FTO, MC4R, and LEP/LEPR genes, modulate appetite and metabolism, thereby increasing susceptibility to obesity. Epigenetic modifications, including DNA methylation and histone modifications, have been demonstrated to play a crucial role in the regulation of metabolic genes. These modifications are significantly influenced by factors such as diet, physical activity, and circadian rhythm disruptions. The gut microbiota has been shown to play a pivotal role in the regulation of energy homeostasis, with its composition being significantly influenced by dietary habits, physical activity levels, and bariatric surgery interventions. Contemporary therapeutic methodologies, including microbiome modulation, the activation of brown adipose tissue, and epigenetic interventions, hold considerable promise for the treatment of obesity. The findings emphasise the necessity for personalised therapeutic strategies that incorporate behavioural, pharmacological, and microbiota-targeted approaches, with the potential to significantly enhance future clinical outcomes.