Key result
Managing obesity requires balancing benefit-risk profiles across lifestyle, pharmacotherapy, devices, and bariatric surgery.
Why the study?
Despite the high prevalence of obesity and its link to cardiovascular disease, effective long-term management strategies remain challenging due to adherence and physiological adaptations.
This review summarizes the pathophysiology of obesity and outlines current management strategies including lifestyle modification, pharmacotherapy, devices, and bariatric surgery.
Obesity continues to be among the top health concerns across the globe. Despite our failure to contain the high prevalence of obesity, we now have a better understanding of its pathophysiology, and how excess adiposity leads to type 2 diabetes, hypertension, and cardiovascular disease. Lifestyle modification is recommended as the cornerstone of obesity management, but many patients do not achieve long-lasting benefits due to difficulty with adherence as well as physiological and neurohormonal adaptation of the body in response to weight loss. Fortunately, 5 drug therapies-orlistat, lorcaserin, liraglutide, phentermine/topiramate, and naltrexone/bupropion-are available for long-term weight management. Additionally, several medical devices are available for short-term and long-term use. Bariatric surgery yields substantial and sustained weight loss with resolution of type 2 diabetes, although due to the high cost and a small risk of serious complications, it is generally recommended for patients with severe obesity. Benefit-to-risk balance should guide treatment decisions.
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Gadde et al. (2018) conducted a review in Obesity. Obesity management requires a benefit-to-risk assessment of available options, including lifestyle modification, five approved drug therapies, medical devices, and bariatric surgery for severe cases.
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