TY - JOUR
T1 - Successful naltrexone-bupropion treatment after several treatment failures in a patient with severe monogenic obesity
AU - Welling, Mila S.
AU - Mohseni, Mostafa
AU - van der Valk, Eline S.
AU - van Hagen, Johanna M.
AU - Burgerhart, Jan Steven
AU - van Haelst, Mieke M.
AU - van Rossum, Elisabeth F.C.
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/3/17
Y1 - 2023/3/17
N2 - We describe the therapeutic journey of a 33-year-old patient with early-onset obesity (BMI 56.7 kg/m2) and hyperphagia due to a likely pathogenic heterozygous melanocortin-4 receptor (MC4R) gene variant. She was unsuccessfully treated with several intensive lifestyle interventions, gastric bypass surgery (−40 kg weight loss, followed by +39.8 kg weight regain), liraglutide 3 mg (−3.8% weight loss with sustained hyperphagia), and metformin treatment. However, naltrexone-bupropion treatment led to −48.9 kg (−26.7%) weight loss, of which −39.9 kg (−38.3%) was fat mass, in 17 months of treatment. Importantly, she reported improved hyperphagia and quality of life. We describe the potential beneficial effects of naltrexone-bupropion on weight, hyperphagia, and quality of life in a patient with genetic obesity. This extensive journey shows that various anti-obesity agents can be initiated, subsequently terminated when ineffective and substituted with other anti-obesity agents to identify the most efficient anti-obesity treatment.
AB - We describe the therapeutic journey of a 33-year-old patient with early-onset obesity (BMI 56.7 kg/m2) and hyperphagia due to a likely pathogenic heterozygous melanocortin-4 receptor (MC4R) gene variant. She was unsuccessfully treated with several intensive lifestyle interventions, gastric bypass surgery (−40 kg weight loss, followed by +39.8 kg weight regain), liraglutide 3 mg (−3.8% weight loss with sustained hyperphagia), and metformin treatment. However, naltrexone-bupropion treatment led to −48.9 kg (−26.7%) weight loss, of which −39.9 kg (−38.3%) was fat mass, in 17 months of treatment. Importantly, she reported improved hyperphagia and quality of life. We describe the potential beneficial effects of naltrexone-bupropion on weight, hyperphagia, and quality of life in a patient with genetic obesity. This extensive journey shows that various anti-obesity agents can be initiated, subsequently terminated when ineffective and substituted with other anti-obesity agents to identify the most efficient anti-obesity treatment.
KW - Biological sciences
KW - Human metabolism
KW - Human Physiology
KW - Physiology
UR - http://www.scopus.com/inward/record.url?scp=85150466527&partnerID=8YFLogxK
U2 - 10.1016/j.isci.2023.106199
DO - 10.1016/j.isci.2023.106199
M3 - Article
AN - SCOPUS:85150466527
VL - 26
JO - iScience
JF - iScience
IS - 3
M1 - 106199
ER -