CME 
JOBS 
OUTBREAKS 
PEER-TO-PEER 
QUIZZES & QUESTIONS 
MEDTECH Are we optimally leveraging the power of pharmacological interventions in the fight against the global obesity epidemic?
This CME discussion between Dr. Chuck Vega and Dr. Donna Ryan explores the challenges of weight management, the physiology of obesity, and the role of medications in weight-loss.
Key Points:
- Obesity, classified by excess abnormal body fat that impairs health, is a major global health concern. Lifestyle modifications often fall short, thus highlighting the need for pharmacological interventions.
- Body Mass Index (BMI) is a good population-level measure but requires additional parameters like waist circumference and cardiometabolic risk factors for clinical diagnosis.
- Obesity results from genetic susceptibility interacting with an obesogenic environment and medications that can promote weight gain.
- Weight loss is challenged by increased appetite and reduced metabolic rate. Pharmacological interventions, particularly those affecting appetite, can support more effective weight management.
- Anti-obesity medications such as orlistat, naltrexone/bupropion, phentermine/topiramate, liraglutide, and semaglutide have been approved since 2012 for chronic weight management.
- The GLP-1 receptor agonists like liraglutide and semaglutide have shown promising results, with semaglutide reporting an average weight loss of 15% to 17%. The dual-action GLP-1 and GIP receptor agonist tirzepatide is under FDA review and could result in 15% to 22% average weight loss.
- The medications have potential side effects and should be prescribed with caution.
- Pharmacological treatment is most beneficial for those needing to lose weight for health reasons, with a BMI of 30 or higher or 27 with at least one obesity-related comorbidity.
Additional Points:
- Weight loss medications are most effective in conjunction with healthier diets and increased physical activity.
- The proposal of weight loss medications should align with a patient’s readiness and need for more intensive weight management.
- Physicians should avoid proposing weight loss to older and sicker patients, during pregnancy, or in a way that could be perceived as body size judgement.
Conclusion:
- A deeper understanding of the physiology of obesity and the appropriate use of weight-loss medications can aid physicians in managing obesity more effectively, achieving better patient outcomes, and potentially improving global health.
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“And the last thing we want to do is propose a weight-loss effort and have it send patients away, have patients believe that we’re judging their body size. So if patients say, ‘No, it’s not a good time for me to try to lose weight,’ we have to accept that…”
Donna Ryan, MD
