Case Study: 

Sarah, a 15-year-old girl with PWS, struggles with constant hunger and weight management. Despite following a strict diet and exercise program, she grapples with uncontrollable cravings and frequent overeating episodes. Sarah’s doctors suspect a hormonal imbalance contributing to her hyperphagia and explore incretins as potential culprits.

The Investigation:

• Blood tests reveal low levels of GLP-1, confirming suspicions of its blunted response in Sarah’s gut.
• Further tests suggest potential overactivity of GIP, adding another layer to the metabolic puzzle.

The Discordant Duet:

• Diminuished GLP-1: Weak satiety signals lead to Sarah’s relentless hunger, delayed gastric emptying contributes to overeating, and impaired insulin secretion adds to blood sugar concerns.
• Overactive GIP: Enhanced fat storage may hinder weight management, and potential appetite stimulation fuels Sarah’s hyperphagia, creating a vicious cycle.

Tuning the Melody:

Sarah’s doctors consider two therapeutic approaches:

• GLP-1 agonists: Liraglutide is prescribed, mimicking GLP-1’s actions to boost satiety, slow digestion, and improve insulin secretion, potentially reducing Sarah’s hunger and aiding weight management.
• GIP antagonists: Atrasentan is explored as a trial therapy, potentially blocking GIP’s appetite-stimulating effects and providing additional support for curbing Sarah’s hyperphagia.

The Hopeful Score:

With close monitoring and adjustments, Sarah experiences encouraging results. GLP-1 agonists curb her cravings, reduce overeating episodes, and help stabilize her blood sugar. Atrasentan further dampens her hunger, leading to gradual weight loss.

While Sarah’s journey continues, the incretin-based approach offers a glimmer of hope in managing her PWS symptoms. Balancing the GLP-1 vs. GIP tango has become a key element in her fight against hyperphagia and metabolic challenges.

Unveiling the Neurochemical Dance of Sarah’s Anxiety