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Innovative Medicines & Omics Pharmacotherapy of obesity

and absorption of nutrients. Psyllium has been shown adjunct therapy for metabolic disorders, with data
to improve glycemic control in patients with metabolic indicating that cannabis users tend to have lower BMI.
syndrome and Type 2 diabetes, as well as reduce cholesterol However, additional research is necessary, especially
levels in patients with hypercholesterolemia. Several trials concerning its effect on non-alcoholic fatty liver disease
have also shown that psyllium can help reduce body weight in humans. Therapeutic potential of CBD could help
in overweight or obese individuals. 87 mitigate inflammation and comorbidities associated with
obesity. Nonetheless, it will most likely be employed as a
12.7. Melatonin supplementary therapy rather than a primary treatment. 93,94

The pineal hormone melatonin (N-acetyl-5-
methoxytryptamine) is characterized by multiple actions 13. Conclusion
in the regulation of the circadian rhythm and weight Obesity is defined as a complex physical process in
88
control. It acts on insulin synthesis and sensitivity, which fat accumulates in the body. Obesity causes critical
which is important for the maintenance of normal glucose health consequences, spanning from heart diseases to
levels. Melatonin promotes metabolic function through certain forms of cancer. As a multifactorial condition,
the regulation of GLUT4 expression and the activation of its occurrence is more particularly attributed to genetic
insulin signaling pathways. Besides, melatonin takes part in and behavioral factors. Behavioral factors mainly include
energy balance through the stimulation of brown adipose poor eating habits. People who consume high-calorie/
tissue and browning of white adipose tissue, enhancing low-nutrient foods and who are living a sedentary lifestyle
energy expenditure. Disruptions in the production of tend to become obese, and if compounded by a genetic
melatonin with aging and/or environmental factors may predisposition and hormonal imbalances, particularly
affect insulin resistance, glucose intolerance, and obesity. 89 with regard to leptin and insulin resistance, their chances
Recent studies have shown that melatonin is useful of fat accumulation will be increased.
for weight loss and for reducing fat mass. Animal studies Weight loss is achieved by lifestyle changes, such as a
showed that melatonin decreases weight gain and enhances balanced diet and regular physical activity. Furthermore,
fat loss, whereas some clinical trials in humans reported a pharmacological treatment provided by drugs, such as
reduction in body weight and BMI. Although a 2017 meta- orlistat, liraglutide, phentermine/topiramate, naltrexone/
analysis revealed no significant effect on body weight, some bupropion, metreleptin, setmelanotide, semaglutide, and
recent clinical trials have suggested that melatonin may be tirzepatide or supplements intake can support weight
a useful dietary supplement for weight management. In loss either by reducing fat absorption or by regulating
light of such positive results, further meta-analyses are appetite. In more severe cases of obesity, weight loss can be
warranted to establish a more definitive role of melatonin achieved by bariatric surgery as the last resort. Under most
in obesity management. In an attempt to personalize the circumstances, the methods used to lose weight are subject
dose of melatonin, based on patients’ needs, scientists to personal preferences. At present, ongoing research into
also applied 3D printing technology for the preparation of genetic and metabolic factors in the context of obesity
tablets and oral films. 90-92 will continue to offer hope for the development of more

12.8. Cannabidiol targeted and effective treatments.
Many researchers have shown that cannabis-based Acknowledgments
remedies can treat a range of metabolic syndrome None.
components such as obesity, high blood pressure, impaired
glucose metabolism, and non-alcoholic fatty liver disease, Funding
with cannabidiol (CBD; 2-[(1R,6R)-6-Isopropenyl-3-
methylcyclohex-2-en-1-yl]-5-pentylbenzene-1,3-diol) This work was supported by the Hellenic Foundation for
th
being of particular interest. More specifically, CBD may Research and Innovation (HFRI) under the 5 Call for
help sensitize adipose tissue to insulin and decrease fasting HFRI PhD Fellowships grant to C.P. (Fellowship Number:
glucose levels, although results have been inconsistent. 20610).
CBD also demonstrates potential in improving lipid Conflict of interest
profiles, lowering LDL, and increasing high-density
lipoprotein. While CBD’s hypotensive effects are moderate, Marilena Vlachou is an Editorial Board Member of this
it has been found to stabilize blood pressure and safeguard journal but was not in any way involved in the editorial
blood vessels. Its anti-inflammatory, antioxidant, and and peer-review process conducted for this paper, directly
neuroprotective characteristics make it an appealing or indirectly. Separately, other authors declared that they

Volume 2 Issue 2 (2025) 14 doi: 10.36922/imo.8316