The efficacy and safety of liraglutide 3.0 mg versus placebo, as adjunct to diet and exercise, was evaluated in racial subgroups. This post hoc analysis of pooled data from five double‐blind randomized, placebo‐controlled trials was conducted in 5325 adults with either a body mass index (BMI) ≥27 kg/m2 plus ≥1 comorbidity or a BMI ≥30 kg/m2. Statistical interaction tests evaluated possible treatment effect differences between racial subgroups: white (4496, 84.4%), black/African‐American (550, 10.3%), Asian (168, 3.2%) and other (111, 2.1%). Effects of liraglutide 3.0 mg on weight loss, associated metabolic effects and safety profile were generally consistent across racial subgroups. All achieved statistically significant mean weight loss at end‐of‐treatment with liraglutide 3.0 mg versus placebo: white 7.7% versus 2.3%, black/African‐American 6.3% versus 1.4%, Asian 6.3% versus 2.5%, other 7.3% versus 0.49%. Treatment effects on weight and cardiovascular risk markers generally showed no dependence on race (interaction test p > 0.05). Adverse events were similar across racial subgroups.

Obesity is a growing public health crisis in the United States and is associated with a substantial disease burden due to an increased risk for multiple complications, including cardiovascular and metabolic diseases. As highlighted in this review, obesity disproportionately affects the African American population, women in particular, regardless of socioeconomic status. Structural racism remains a major contributor to health disparities between African American people and the general population, and it limits access to healthy foods, safe spaces to exercise, adequate health insurance, and medication, all of which impact obesity prevalence and outcomes. Conscious and unconscious interpersonal racism also impacts obesity care and outcomes in African American people and may adversely affect interactions between health care practitioners and patients. To reduce health disparities, structural racism and racial bias must be addressed. Culturally relevant interventions for obesity management have been successfully implemented that have shown benefits in weight management and risk‐factor reduction. Strategies to improve health care practitioner–patient engagement should also be implemented to improve health outcomes in African American people with obesity. When managing obesity in African American people, it is critical to take a holistic approach and to consider an individual's social and cultural context in order to implement a successful treatment strategy.

* With the shift toward value-based patient care, greater emphasis has been placed on improving patient outcomes, reducing complications, and minimizing hospital costs. Optimal care therefore requires a multidisciplinary approach for perioperative patient optimization and episode management.* Here we review the case of a 48-year-old woman with symptomatic osteoarthritis of the left hip and multiple medical comorbidities. We present appropriate optimization guidelines from a panel of multidisciplinary experts in their respective specialties.* Continued clinical research is critical with regard to perioperative optimization and disease episode management as part of population health initiatives and will enable us to better identify at-risk patients early in the process. This will promote the development of improved evidence-based screening criteria and guidelines allowing for the optimization of patient outcomes, safety, and satisfaction following total joint arthroplasty.* Historically, surgical risk stratification methods have emphasized the appraisal of non-modifiable risk factors. Consequently, this has incentivized surgeons to operate on healthy, low comorbidity burden patients, while avoiding surgical intervention on unhealthy, high-comorbidity patients. Only recently has the medical optimization of high-risk candidates undergoing total joint arthroplasty demonstrated improved outcomes by reducing hospital readmissions when patients undergo total joint arthroplasty after optimization.

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