The exploration of combination strategies, such as GLP-1 RAs with setmelanotide in patients retaining partial MC4R function, may offer additive benefits by targeting both MC4R -dependent and MC4R -independent pathways
But it means its even more important to plan what happens after weight lossdietary change and physical activity remain essential. Ongoing research is exploring maintenance-phase strategies, lower dosing and alternative compounds that might preserve metabolic benefits while minimizing side effects
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Additionally, exenatide increased cerebral glucose metabolism in regions associated with glucose homeostasis, appetite, and food reward, as observed through [(18)F]2-fluoro-2-deoxy-d-glucose PET/CT scans [17,18,19]
Setmelanotide, while mechanistically rational, lacks confirmatory trial data specifically for MC4R -deficient obesity and should be regarded as an exploratory option at present