A dietary intervention following incretin analog treatment restores adipose tissue functions in diet-induced obese mice

Obesity affects more than 15% of the world population and is associated with the development of glucose intolerance and type 2 diabetes. In recent years, incretin analogs are prescribed at a high rate for treatment of obesity and diabetes due to their potent effects on lowering bodyweight and improving glucose homeostasis. However, recent studies suggest that many patients do not stay on incretin analog therapy and thereby rapidly regain bodyweight. The non-compliance of patients to incretin analog therapy is not only due to drug shortage but also insufficient knowledge on the long-term effects of the therapy. To address this knowledge gap and provide a long-term therapy strategy for obesity, we examined the effects of incretin analog treatment and withdrawal on adipose tissue functions in diet-induced obese mice. Our transcriptome data suggest that incretin analog treatment restored most of obesity-mediated deregulated gene expression in adipose tissue. However, genes encoding lipogenic enzymes, downregulated by diet-induced obesity, were not restored by incretin analog treatment. Upon therapy withdrawal, mice displayed rapid bodyweight regain, impaired adipose tissue function, and glucose intolerance. In contrast, a dietary intervention following incretin analog therapy withdrawal restored lipogenic gene expression in adipose tissue, maintained glucose homeostasis, increased lean mass and minimized body weight regain. Our findings revealed the effects of incretin analog therapy and therapy withdrawal on adipose tissue and highlight the importance of a dietary intervention following incretin analog therapy, which may contribute to the development of long-term therapy guidelines of incretin analog therapy for patients with obesity.