One of the themes we talked about on today’s live is that we often speak about obesity as though it’s one disease. In reality, it may be more accurate to think of obesity as a family of diseases. Two people can have the same BMI and the same amount of weight to lose, yet the biology driving their obesity may be completely different. For one person, insulin resistance may play the biggest role. For another, it could be leptin signaling, inflammation, genetics, or pathways in the brain that scientists are only beginning to understand. They may all arrive at the same destination, excess body fat, but they may have taken very different biological roads to get there.
That’s why a new experimental obesity drug presented this week caught my attention. The company Kalohexis shared early research on an oral medication called 710GO at the International Congress on Obesity. Unlike GLP-1 medications such as Wegovy or Zepbound, this drug doesn’t target the GLP-1 receptor at all. Instead, it activates two receptors in the brain called MC3R and MC4R, which are part of a network known as the melanocortin system. While that may sound like scientific jargon, the underlying idea is actually fairly straightforward.
Think of the melanocortin system as one of your body’s metabolic control centers. It’s constantly processing information about how much energy you’ve stored, how hungry you are, how many calories you’re burning, and how strongly your body wants to defend its current weight. The MC3R and MC4R receptors are two important switches within that system. When they’re functioning properly, they help regulate appetite, metabolism, and energy balance, working behind the scenes to help determine when you eat, how much you eat, and how your body uses the calories you consume.
If the MC4 receptor sounds familiar, there’s a reason. An FDA-approved medication called Imcivree, also known as setmelanotide, already targets this pathway. However, it’s approved only for people with a handful of very rare genetic forms of obesity caused by defects in the melanocortin system itself. For those patients, treating that underlying biology can produce remarkable results. What makes Kalohexis’ research exciting is that scientists are now asking whether this same pathway could also help the millions of people living with more common forms of obesity who don’t have those rare genetic mutations.
In studies involving obese monkeys, the company reported meaningful weight loss while preserving more lean muscle (about 90% of weight lost was fat) and seeing promising data on weight regain after stopping treatment. Those findings are noteworthy because obesity medicine is evolving beyond simply asking how much weight someone can lose. Researchers are increasingly focused on helping people lose a greater percentage of fat while preserving muscle, since muscle is essential for strength, mobility, metabolic health, and healthy aging. They’re also searching for ways to make weight loss more durable so patients are less likely to regain weight if treatment is interrupted.
It’s important to remember that these findings come from animal studies, not human clinical trials. While studies in nonhuman primates are generally more predictive than studies in rodents, many therapies that look promising in animals ultimately fail to produce the same results in people. The encouraging news is that 710GO has already entered Phase 1 clinical testing, meaning researchers have officially begun evaluating its safety in humans. That represents an important milestone, but there is still a long journey before anyone knows whether this medication will become an approved treatment.
For me, though, the most interesting part of this announcement isn’t the drug itself. It’s what it says about where obesity science continues to head. Inn recent years, much of the industry focused on nutrient stimulated hormone pathways. Today, researchers are studying GLP-1, GIP, glucagon, amylin, leptin, inflammation, genetics, muscle biology, mitochondrial function, which has perhaps renewed interest in the melanocortin system. Every one of these discoveries reminds us that obesity is far more biologically complex than most people realize.
That complexity may ultimately change how we think about obesity altogether. Instead of asking, “What’s the best obesity medication?” we may someday ask, “What type of obesity does this person have?” Just as cancer is no longer viewed as one disease but hundreds of diseases requiring different treatments, obesity may eventually be understood in much the same way. The more we learn about the biological pathways involved, the better equipped we’ll be to match the right treatment to the right patient.
Whether 710GO ultimately succeeds or not, I think this research deserves attention because it reinforces a message I’ve been sharing for years. Obesity isn’t a failure of willpower, and it isn’t caused by a single hormone or a single biological mistake. It’s an incredibly complex chronic disease involving dozens of interconnected systems throughout the brain and body. Every time researchers uncover another one of those systems, they move us one step closer to more personalized, more effective treatments for the millions of people living with obesity. That’s a future worth watching, and we are here for it!
