<b><i>Introduction:</i></b> Data from randomized controlled trials show that liraglutide 3.0 mg, in combination with diet and exercise, is associated with greater weight loss than diet and exercise alone in patients with obesity. In practice, the utilization of weight loss drugs is influenced by various factors, including the cost of treatment. We conducted a retrospective, observational study to assess the effectiveness of liraglutide 3.0 mg and patients’ persistence on treatment, in a real-world setting. <b><i>Methods:</i></b> Data were extracted from de-identified electronic medical records from an obesity management clinic in Switzerland. Changes in body weight and blood pressure were evaluated in the full cohort (<i>N</i> = 277, 19% of whom had undergone bariatric surgery) and subgroups who were persistent on liraglutide 3.0 mg for at least 4 months (<i>n</i> = 236), 7 months (<i>n</i> = 159), or 12 months (<i>n</i> = 71). <b><i>Results:</i></b> Median persistence on liraglutide was 6.8 months. Median maximum dose received was 1.5 mg, and 13.7% of patients reached the maintenance dose of 3.0 mg. Mean 7-month weight change from baseline in the full cohort was −4.1 kg (95% confidence interval: −5.0, −3.2; <i>p</i> < 0.001; −4.2%). Weight change was −4.4 kg (−4.7%) in the ≥4-month persistence subgroup at 4 months, −5.1 kg (−5.3%) in the ≥7-month persistence subgroup at 7 months, and −7.5 kg (−7.1%) in the ≥12-month persistence subgroup at 12 months (all <i>p</i> < 0.001). In the full cohort, 40% and 14% of patients lost ≥5% and >10% of body weight at 7 months, respectively. Weight loss did not differ significantly according to history of bariatric surgery (<i>p</i> = 0.94). Diastolic blood pressure decreased (from 87.0 to 83.9 mm Hg at 7 months; <i>p</i> = 0.018), with no significant changes in systolic blood pressure. Approximately two-thirds of patients did not have health insurance that could cover the cost of liraglutide. <b><i>Conclusion:</i></b> In a real-world setting with low insurance coverage and with most patients not reaching the recommended maintenance dose of 3.0 mg, the use of liraglutide, in combination with diet and exercise, was associated with clinically meaningful weight loss.
Background: Obesity is one of the greatest public health challenges worldwide. It is not only a medical but also a philosophical, ecological, economic, sociocultural, and psychological problem as well as a severe consequence of our modern value definition to ‘receive more and more'. Therefore, physicians are not able to treat obesity broadly and should not be used as tools to achieve certain weight goals. Methods: This article presents an outline of conservative obesity therapy. Using the key words ‘obesity', ‘diet', and ‘exercise', a search was conducted in the PubMed and ScienceDirect databases for the period from 1995 to 2015. Results/Conclusion: The goal of obesity therapy is primarily the reduction of abdominal fat distribution. Only after achieving this main objective, weight loss reduction can be included by changes in eating and activity habits as well as further lifestyle modifications supplemented by weight-reducing medical, invasive, and/or surgical therapy measures in order to reduce obesity-associated comorbidities and to improve quality of life. A reduction of fat intake while avoiding unsaturated fatty acids, an optimization especially of the quality of carbohydrate and protein intake, an increase in physical activity (about 30-60 min per day) with individual adaption, and a personal, ongoing therapeutic leadership is necessary to reach the main goal, i.e. losing 5-15% of the initial weight.
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