## 4 Treatment Advancements
### Obesity Treatments
While still under investigation, FMT has shown promise in some studies. A recent meta-analysis and systematic review of FMT trials in obesity demonstrated significant improvements in body fat percentage, HbA1c, and insulin sensitivity [54; 55]. However, there was no significant difference between the FMT groups and the placebo groups in terms of weight reduction. However, the long-term efficacy and safety of FMT require further exploration. **Pharmaceutical Advancements:** Over the years, many anti-obesity medications (AOMs) have been tried to treat obesity, but most have been withdrawn because of safety concerns. For example, in early 2020, the US Food and Drug Administration (FDA) withdrew lorcaserin from the market because of evidence of increased cancer risk [56], and phentermine plus topiramate is approved only in the United States [57]. So, developing effective AOM has proven remarkably difficult due to both scientific and social complexities. Only in the past two decades have we gained a deep enough un derstanding of the molecular pathways regulating appetite to allow for a targeted approach to drug discovery. New agents that function by decreasing appetite or providing satiety have been approved by global food authorities over the past decade for chronic weight control [58], including bupropion plus naltrexone [59] and glucagon-like peptide-1 receptor agonists (GLP-1 RAs), with two familiar representatives: iliraglutide and semaglutide [60]. The recent approval in 2021 by the FDA of semaglutide has marked a significant breakthrough in pharmaceutical interventions for obesity. These medications mimic the actions of a natural gut hormone, GLP-1, which promotes satiety, reduces appetite, and slows down stomach emptying [61; 62]. Clinical trials have shown remarkable weight loss results with GLP-1 RAs, offering new hope for individuals struggling with obesity. Existing GLP-1 RAs, such as semaglutide, have demonstrated efficacy in achieving a weight loss of 15-17% [63; 64; 65]. However, even greater results are emerging with newer dual agonist GLP-1 RAs like tirzepatide, which has shown promise in clinical trials, with weight loss reaching up to 22.5% [66; 67]. Researchers are actively exploring additional pharmaceutical targets that might influence factors like metabolism, fat storage, and energy expenditure. **Emerging Technologies:** The fight against obesity extends beyond established methods. Novel brain stimulation therapies, along with the recent developments in the digital area offer promising tools for weight management, paving the way for more targeted and individualized approaches. _Brain Stimulation Therapies:_ Neuromodulation techniques like deep brain stimulation (DBS) are being explored for their potential roles in regulating appetite and food cravings. While still in the early stages of research, DBS offers a glimmer of hope for individuals with severe obesity who have not found success with traditional methods [68; 69]. _Cognitive Behavioral Therapy (CBT):_ Obesity is a complex condition with significant psychological and behavioral components. Cognitive behavioral therapy (CBT) has been shown to be effective in helping individuals develop healthy eating habits, increase physical activity levels, and manage stress--all crucial aspects of weight management. The integration of CBT alongside other treatment modalities offers a holistic approach to managing obesity and promoting long-term success [70; 71]. _Prescription Digital Therapeutics (PDTs):_ PDTs are revolutionizing weight management by offering FDA-approved apps and software programs that go beyond simple calorie counting. These personalized programs provide users with features like meal planning, behavior modification guidance, self-monitoring tools, and even virtual coaching--all conveniently accessible on a mobile device. PDTs create a comprehensive picture of health and empower individuals to take an active role in their weight loss journey [72; 73; 74].