The notion that obesity is simply a result of weak will or “weakness of character” is now definitively refuted by modern scientific data. Today, the global medical community recognizes obesity as a complex, chronic and relapsing neuro-hormonal disease. It is a condition that requires the same seriousness, scientific documentation and long-term management strategy as any other chronic disease — from diabetes to hypertension.
For the Greek diaspora worldwide, access to valid, scientific information about developments in the homeland and the international field of health is a constant requirement. In the following interview, the distinguished Pathologist specializing in Diabetes Mellitus, Dr. Evangelos Fousteris, Treasurer of the Panhellenic Society for the Study of Obesity, maps the new therapeutic landscape, speaking to GreekNews and Radio FL.
Mr. Fousteris analyzes the impressive results of the newest pharmaceutical treatments, presents for the first time the groundbreaking Greek real-world data from a nationwide study, and takes a frank stance on the critical issue of state funding and patient accessibility to new therapies.
- Mr. Fousteris, would we like to refer to the modern scientific framework for recognizing obesity as a disease?
"In recent years, the way in which the scientific community understands obesity has changed radically. Today, it is recognized as a chronic, complex and recurrent neuro-hormonal disease, which is not simply due to "overeating" due to lack of will or weakness of character, but results from the interaction of genetic (up to 70%), biological, hormonal, psychological, social and environmental factors. The human body has strong biological mechanisms that resist weight loss, which explains why its long-term maintenance is so difficult without appropriate therapeutic support.
At the same time, our therapeutic approach has also changed. We no longer treat obesity exclusively as a problem of aesthetics or numbers on the scale, but as a disease associated with many metabolic complications (hyperlipidemia, prediabetes, type 2 diabetes, cardiovascular diseases, fatty liver disease, hyperuricemia, infertility, etc.), as well as mechanical complications (sleep apnea syndrome, osteoarthritis, gastroesophageal reflux, etc.), but also at least 13 forms of cancer and many more complications from the psycho-emotional sphere. Therefore, the main goal of treatment is to improve the patient's overall health, functionality and quality of life.
- What is the modern therapeutic intervention?
"Modern treatment is individualized and multidimensional. It includes nutritional intervention, recommendations for increased physical activity, support for behavior change, modern medication when indicated, and, in selected cases, metabolic-bariatric surgery."
The choice of appropriate treatment is based not only on body mass index, but also on the presence of complications, the overall health status and the needs of each patient. The most important message is that obesity is a disease that can and should be treated with the same seriousness and scientific evidence as any other chronic disease. Today we have effective treatment options that can reduce the risk of complications, improve quality of life and extend life expectancy. The benefits, therefore, from the pharmaceutical management of obesity extend much further than the narrow framework of the number on the scale. We are now talking about recovering the health of sufferers.
- In this field of newer pharmaceutical treatments, what's new?
"At the recent European Obesity Congress (ECO) in Istanbul, new data were announced regarding the pharmaceutical treatments we already have, as well as many data regarding new pharmaceutical agents that are under development.
a. High efficacy from subcutaneously administered weekly Semaglutide at 7.2 mg:
The researchers showed that patients who respond quickly to treatment with semaglutide 7,2 mg – that is, achieve a loss of at least 15% of body weight within the first 24 weeks – can achieve an average total weight loss of almost 28% after 72 weeks of treatment. Moreover, most of this loss came from fat mass, with a significant reduction in visceral fat, which is directly related to cardiometabolic risk. The most important message, however, is that early response appears to be a strong predictor of future treatment success. These findings strengthen the prospect of a more personalized approach to the treatment of obesity, while confirming that modern drug therapies can achieve results that until a few years ago were considered possible only with bariatric surgery.
b. Weekly administered Tirzepatide: Highest efficacy that lasts:
Tirzepatide is currently the most effective drug available in terms of absolute weight loss (SURMOUNT-1 study, -22.5%). The results of the SURMOUNT-MAINTAIN study, presented at ECO 2026, were also extremely important and confirm that obesity is a chronic disease that requires long-term treatment. Patients who continued Tirzepatide at the maximum tolerated dose maintained almost all of the weight loss they had achieved for the more than 2 years that the study lasted, while even those who reduced the dose to 5 mg maintained a significant part of the benefit. On the contrary, discontinuation of treatment led to significant weight regain and partial reversal of the cardiometabolic benefits. Therefore, we are talking about a dose-dependent effect that lasts without specific safety signals. The message is clear: as with hypertension or diabetes, obesity treatment should not be seen as a short-term intervention, but as a long-term strategy. Continuing treatment, at the right dose and with an individualized approach, is crucial for maintaining weight loss and significant health benefits.”_
Evangelos Fousteris, MD, Ph.D.
Internist specializing in Diabetes Mellitus Medical Director Mediterranean Diabetes & Obesity Clinics
Treasurer of the Panhellenic Society for the Study of Obesity
