Genetic Testing Enhances Personalization of Weight-Loss Treatments

Mayo Clinic researchers have devised a groundbreaking genetic test that forecasts individual responses to certain weight-loss medications, including GLP-1 drugs. The test measures a person’s calories to satiation (CTS), which indicates how much food is needed to feel full, and links this trait to the likelihood of treatment success. This innovative approach aims to tailor obesity treatments based on a person's biological profile, moving beyond conventional measures like BMI.

The study, published in Cell Metabolism, highlights the importance of understanding the biological factors influencing appetite and weight regulation. By analyzing genetic variants in 10 genes associated with food intake, researchers created the CTS-GRS (Calories to Satiation Genetic Risk Score), a personalized metric derived from blood or saliva samples. This score predicts an individual’s satiation threshold, providing insights into how they might respond to specific weight-loss drugs.

In clinical trials, the team applied the CTS-GRS to assess responses to two FDA-approved medications: phentermine-topiramate (Qsymia) and liraglutide (Saxenda). Results indicated that individuals with higher satiation thresholds generally experienced greater weight loss with phentermine-topiramate, which assists in controlling large-meal overeating. Conversely, those with lower thresholds responded more favorably to liraglutide, which reduces overall hunger and the frequency of eating.

Dr. Andres Acosta, senior author of the study, emphasized the potential for this genetic test to optimize treatment plans. "With one test, we can predict which medication will likely be most effective for a patient, leading to more cost-effective care and improved outcomes."

The researchers are already working on expanding the testing to include data from the microbiome and metabolome and aim to develop models predicting side effects like nausea. This personalized approach represents a significant stride towards precision medicine in obesity management.

Obesity, affecting over 650 million adults worldwide, is a complex disease driven by genetic, environmental, and behavioral factors. This complexity explains why individuals respond differently to weight-loss interventions, often relying on simplistic measures like BMI for treatment decisions. By focusing on biological processes such as satiation, this study offers a new pathway to more effective, personalized treatments that address the root causes of weight gain and loss.