Much of the world seems stuck on chasing ever higher numbers for weight loss. But clearly we need better targets for innovation in obesity and metabolic health. At the recent BIO Investment & Growth Summit, Immunis CEO Hans Keirstead came to tell us the answer lies in the health of our muscles. He has a point. Evidence is surfacing that measures of muscle health and body composition might offer better targets for innovation in obesity than simple weight loss.

Targeting Function

Immunis is targeting something altogether different than body weight. In their ongoing phase 2 study of IMM01-STEM, the primary efficacy outcome measure is gait speed. For the population they are studying – older patients with sarcopenia and obesity – this is a vital indicator of how well a person can function. Just losing weight is nice. But it is even better if the result is a significant improvement in a person’s ability to function.

Interim results with IMM01-STEM in this study showed a 26% improvement in gait speed for the treatment group. Immunis Principal Scientist Nicole Berchtold called these findings “highly encouraging” because gait speed is a good predictor of biological age, physical and cognitive status, risk of hospitalization, disability and death.

Shifting the Frame Is Hard

There is little doubt about the need for better targets in obesity. But it will take time to move people to a different way of thinking about progress in treating obesity. With metabolic surgery and new, advanced therapies for obesity, dramatic weight loss is possible. However, weight loss alone does not tell the whole story.

The improvements in body composition seen recently with the combination of bimagrumab and semaglutide seem dramatic. Even so, the net weight loss was not terribly different than what comes from treatment with tirzepatide all by itself. It was the reduction in adiposity that impressed.

It’s one thing to believe that improvements in body composition and muscle health are important in treating obesity. It is quite another thing to get people – especially regulators like FDA – to think about more than just weight loss. To get there will take time and the accumulation of solid data on health outcomes that result when the quality of weight loss improves. Aiming for better strength and health seems like a good bet.

Click here and here for more about the work on IMM01-STEM. For more on muscle health as a therapeutic target in obesity, click here.

Study for “The Last Judgement,” sketch by Michelangelo / WikiArt