Listen to the Podcast with Dr. Carolyn Francavilla Brown and Dr. Andres Acosta.
Obesity treatment has entered a new era. While blockbuster medications like Wegovy® and Zepbound™ have changed the conversation, not everyone sees the same results. Some people lose 20% of their body weight, while others lose far less—or struggle with side effects. So, how do you know what will work for you?
That’s where precision obesity medicine comes in.
For decades, weight management has often relied on a trial-and-error approach: try a medication, see if it works, and adjust if it doesn’t. Dr. Andres Acosta, physician-scientist at Mayo Clinic and co-founder of Phenomix Sciences, believes we can do better. By applying the principles of precision medicine—already standard in fields like oncology—obesity treatment can move away from one-size-fits-all care.
Instead of guessing, we can identify the root cause of a person’s obesity and match the right therapy to the right patient.
Through years of research, Dr. Acosta and his team discovered that obesity isn’t uniform—it presents in distinct phenotypes. These describe different biological drivers of weight gain:
These phenotypes explain why two people can eat the same foods, take the same medications, and yet have dramatically different outcomes.
To make this science practical for everyday care, Dr. Acosta and colleagues spun out Phenomix Sciences with Mayo Clinic and the AMA’s innovation arm. The result: the MyPhenome® test, a simple cheek swab that uses genetics and AI to identify a patient’s obesity phenotype.
The test helps determine:
In clinical studies, patients with the Hungry Gut phenotype who used GLP-1s lost nearly double the weight compared to non-responders. Those with Hungry Brain, meanwhile, responded best to phentermine-topiramate, an effective and more affordable option.
This is more than a science story—it’s a patient story. Too often, people blame themselves when a treatment doesn’t work. Precision obesity medicine helps reframe the conversation: it’s not your fault—it’s your biology.
By identifying the underlying drivers of weight gain, patients and providers can make smarter, faster decisions, avoid unnecessary side effects, and achieve better outcomes.
Dr. Acosta sees this as just the beginning. Research is underway to predict who will experience side effects, how other medications will perform, and even how to prevent obesity before it develops.
The bottom line: precision medicine is reshaping obesity care, bringing hope and clarity to millions of people who have struggled with weight loss.
