Rethinking obesity, GLP-1s, and the future of metabolic care
A Q&A with Professor Thomas Forst, Chief Medical Officer, hVIVO
Weight loss alone is no longer a meaningful endpoint for obesity. The field has established that much. What it has not yet fully reckoned with is what comes next.
GLP-1 receptor agonists revealed that obesity is a systemic metabolic disease — one whose complications are driven not by the number on a scale, but by ectopic fat accumulation, chronic inflammation, and downstream organ dysfunction. That changes what a therapy needs to demonstrate. It changes how trials should be designed. And it changes what differentiation actually looks like in a market where showing weight reduction is table stakes.
Professor Thomas Forst — physician, cardiometabolic researcher, and CMO at hVIVO — challenges the frameworks still shaping too many development programmes. On fat biology, on the real clinical significance of GLP-1s, and on what the next generation of metabolic therapies will need to show.
In this article, you will learn
- Why morbidity and mortality in obesity are driven by metabolic dysfunction — and what that means for what therapies must demonstrate
- What the clinical evidence now shows about the broader systemic effects of GLP-1 receptor agonists beyond weight reduction
- Why ectopic fat distribution is a stronger predictor of cardiometabolic risk than BMI — and which measures actually tell you more
- What happens to body composition when patients discontinue GLP-1 therapy — and why this is a critical programme design consideration
- Where the field is heading: dual and triple agonists, oral small molecules, and what the next generation must prove
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