2017 / 10 December

Management of Obesity


Obesity as a chronic medical condition and individualization of therapy can improve patient health rather than weight loss per se, according to AACE/ACE Guidelines published on May 24, 2016.

What are the weight loss medications that are FDA-approved for long-term?   

  • Three single drugs (Orlistat, Lorcaserin, and Liraglutide 3 mg)
  • Two combination drugs (Phentermine/topiramate ER and Naltrexone ER/
    bupropion ER)

What are the three main types of bariatric surgery used in the United States?

  • Laparoscopic adjustable gastric banding:  this restrictive procedure is reversible and does not cause anatomical gut changes.
  • Roux-en-Y gastric bypass:  restricts food intake by creating in the upper gastric fundus a small (<50-ml) pouch anastomosed to a Roux limb of jejunum.
  • Vertical-sleeve gastrectomy:  involves removal of approximately 70% of the stomach, with subsequent acceleration of gastric emptying.

Reference

  • Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R; Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY COMPREHENSIVE CLINICAL PRACTICE GUIDELINES  FOR MEDICAL CARE OF PATIENTS WITH OBESITY. Endocr Pract. 2016 Jul;22 Suppl 3:1-203. doi: 10.4158/EP161365.GL.

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