The Niche of n-of-1 Trials in Precision Medicine for Weight Loss and Obesity Treatment: Back to the Future

• Published in: Current nutrition reports Vol. 11; no. 2; pp. 133 - 145
• Main Authors: Grammatikopoulou, Maria G., Gkouskou, Kalliopi K., Gkiouras, Konstantinos, Bogdanos, Dimitrios P., Eliopoulos, Aristides G., Goulis, Dimitrios G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2022
• Subjects: Cardiology; Clinical Nutrition; Diabetes; Diabetes and Obesity (M Dalamaga and F Magkos; Health Promotion and Disease Prevention; Medicine; Medicine & Public Health; Oncology; Section Editors; Topical Collection on Diabetes and Obesity; Precision nutrition; Physical activity; Internet-of-things; Research methodology; Digital health; Weight maintenance; Lifestyle therapy
• ISSN: 2161-3311; 2161-3311
• DOI: 10.1007/s13668-022-00404-5

Purpose of Review The n -of-1 clinical trials are considered the epitome of individualized health care. They are employed to address differences in treatment response and adverse events between patients, in a comparative effectiveness manner, extending beyond the delivery of horizontal recommendations for all. Recent Findings The n -of-1 design has been applied to deliver precision exercise interventions, through eHealth and mHealth technologies. Regarding personalized and precision medical nutrition therapy, few trials have implemented dietary manipulations and one series of n -of-1 trials has applied comprehensive genetic data to improve body weight. With regard to anti-obesity medication, pharmacogenetic data could be applied using the n -of-1 trial design, although none have been implemented yet. Summary The n -of-1 clinical trials consist of the only tool for the delivery of evidence-based, personalized obesity treatment (lifestyle and pharmacotherapy), reducing non-responders, while tailoring the best intervention to each patient, through “trial and error”. Their application is expected to improve obesity treatment and mitigate the epidemic.