Equity in Obesity Review

Advanced microbiome therapeutics as a novel modality for oral delivery of peptides to manage metabolic diseases

The rising prevalence of metabolic diseases calls for innovative treatments. Peptide-based drugs have transformed the management of conditions such as obesity and type 2 diabetes. Yet, challenges persist in oral delivery of these peptides. This review explores the potential of 'advanced microbiome therapeutics' (AMTs), which involve engineered microbes for delivery of peptides in situ, thereby enhancing their bioavailability. Preclinical work on AMTs has shown promise in treating animal models of metabolic diseases, including obesity, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease. Outstanding challenges toward realizing the potential of AMTs involve improving peptide expression, ensuring predictable colonization control, enhancing stability, and managing safety and biocontainment concerns. Still, AMTs have potential for revolutionizing the treatment of metabolic diseases, potentially offering dynamic and personalized novel therapeutic approaches.

Reimagining Urban Spaces: Green Spaces, Obesity, and Health Resilience in an Era of Extreme Heat

Record-breaking heat waves intensified by climate change pose both environmental and health threats, necessitating a balance between urban sustainability and well-being. Extreme heat and limited green space access are drivers of obesity prevalence, with decreased proximity to green spaces correlating with higher rates of obesity in nearby communities. In contrast, access to such green spaces fosters physical activity, well-being, and community cohesion, especially crucial in marginalized communities facing health disparities due to historical policies like redlining and underinvestment in social gathering spaces. Despite challenges, green space investment offers healthcare savings and environmental gains, necessitating a shift in perception towards viewing green spaces as essential for urban living. As heat waves persist, integrating health and sustainability in urban planning is paramount. Health and medical communities must play an active role in advocating for equitable access to urban green spaces, as they possess influential positions to address climate-related health disparities through localized advocacy.

A new era in obesity management

2023 was the most memorable year on record for obesity. The American Academy of Pediatrics recognized the complex, multifactorial nature of obesity and the broad range of treatments necessary to care for pediatric patients. The first-ever triple agonist and high-potency oral GLP1 agonist was introduced with unprecedented results.