AGA Clinical Practice Guideline on Pharmacological Interventions for Adults With Obesity

Grunvald, Eduardo; Shah, Raj; Hernáez, Rubén; Chandar, Apoorva K.; Pickett–Blakely, Octavia; Teigen, Levi; Harindhanavudhi, Tasma; Sultan, Shahnaz; Singh, Siddharth

doi:10.1053/j.gastro.2022.08.045

Cited by 86 publications

(125 citation statements)

References 149 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, for most patients, lifestyle interventions alone cannot reverse hormonal and metabolic abnormalities that come after weight loss; multiple interventions may be required for patients with obesity to sustain medically meaningful weight loss for the clinically significant period of 12 months or more. 1,50 In a November 2022 guideline, the American Gastroenterological Association (AGA) emphasized the particular need for medical therapy. In evaluating safety and total body weight loss reported in randomized controlled trials across FDA-approved pharmacologic agents, the AGA guideline authors strongly recommend that an AOM be added to lifestyle intervention for all adults with obesity who have had insufficient response to lifestyle intervention alone.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

“…In evaluating safety and total body weight loss reported in randomized controlled trials across FDA-approved pharmacologic agents, the AGA guideline authors strongly recommend that an AOM be added to lifestyle intervention for all adults with obesity who have had insufficient response to lifestyle intervention alone. 50 They add that these agents generally need to be used chronically because of the chronic nature of obesity. 50 In the third article of this supplement series, Cornier explores the clinical guidelines for both diagnosis and treatment in greater detail.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

“…50 They add that these agents generally need to be used chronically because of the chronic nature of obesity. 50 In the third article of this supplement series, Cornier explores the clinical guidelines for both diagnosis and treatment in greater detail. 11 The AACE/ACE guidelines do not recommend weight-loss therapy only to prevent cardiovascular events or prolong life in patients…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

“…OBESITY AS A SERIOUS, CHRONIC, RELAPSING, AND TREATABLE DISEASE weight loss for the clinically significant period of 12 months or more. 1,50 FDA-approved treatments for chronic weight management have helped affected persons to achieve and sustain significant weight loss and other health benefits. 15 In particular, pharmacotherapy and a multifaceted approach that involves intensive lifestyle/behavioral therapy is effective, and this strategy should be considered for eligible individuals.…”

Section: S277mentioning

confidence: 99%

See 3 more Smart Citations

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

2022

Am J Manag Care

View full text Add to dashboard Cite

show abstract

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Section: S277mentioning

confidence: 99%

See 2 more Smart Citations

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

2022

Am J Manag Care

View full text Add to dashboard Cite

show abstract

“…A los fármacos más conocidos, como la combinación bupropión-naltrexona, fentermina-topiramato y el orlistat, se han sumado la liraglutida y la semiglutida, que son agonistas de los receptores de GLP-1 8 . Estos últimos fármacos están revolucionando el tratamiento de la obesidad por su mayor eficacia (recomendación Grade 2 C) 8 y se están convirtiendo en un fenómeno social y médico 9 . Ya es frecuente en la consulta del médico de familia que algún paciente nos pregunte sobre su uso o nos solicite la receta.…”

unclassified

¿Podrán los nuevos fármacos frenar la epidemia mundial de la obesidad y el sobrepeso?

Guillem

2023

Atención Primaria

View full text Add to dashboard Cite

Obesity Management in Adults

Elmaleh-Sachs,

Schwartz,

Bramante

et al. 2023

JAMA

View full text Add to dashboard Cite

ImportanceObesity affects approximately 42% of US adults and is associated with increased rates of type 2 diabetes, hypertension, cardiovascular disease, sleep disorders, osteoarthritis, and premature death.ObservationsA body mass index (BMI) of 25 or greater is commonly used to define overweight, and a BMI of 30 or greater to define obesity, with lower thresholds for Asian populations (BMI ≥25-27.5), although use of BMI alone is not recommended to determine individual risk. Individuals with obesity have higher rates of incident cardiovascular disease. In men with a BMI of 30 to 39, cardiovascular event rates are 20.21 per 1000 person-years compared with 13.72 per 1000 person-years in men with a normal BMI. In women with a BMI of 30 to 39.9, cardiovascular event rates are 9.97 per 1000 person-years compared with 6.37 per 1000 person-years in women with a normal BMI. Among people with obesity, 5% to 10% weight loss improves systolic blood pressure by about 3 mm Hg for those with hypertension, and may decrease hemoglobin A1c by 0.6% to 1% for those with type 2 diabetes. Evidence-based obesity treatment includes interventions addressing 5 major categories: behavioral interventions, nutrition, physical activity, pharmacotherapy, and metabolic/bariatric procedures. Comprehensive obesity care plans combine appropriate interventions for individual patients. Multicomponent behavioral interventions, ideally consisting of at least 14 sessions in 6 months to promote lifestyle changes, including components such as weight self-monitoring, dietary and physical activity counseling, and problem solving, often produce 5% to 10% weight loss, although weight regain occurs in 25% or more of participants at 2-year follow-up. Effective nutritional approaches focus on reducing total caloric intake and dietary strategies based on patient preferences. Physical activity without calorie reduction typically causes less weight loss (2-3 kg) but is important for weight-loss maintenance. Commonly prescribed medications such as antidepressants (eg, mirtazapine, amitriptyline) and antihyperglycemics such as glyburide or insulin cause weight gain, and clinicians should review and consider alternatives. Antiobesity medications are recommended for nonpregnant patients with obesity or overweight and weight-related comorbidities in conjunction with lifestyle modifications. Six medications are currently approved by the US Food and Drug Administration for long-term use: glucagon-like peptide receptor 1 (GLP-1) agonists (semaglutide and liraglutide only), tirzepatide (a glucose-dependent insulinotropic polypeptide/GLP-1 agonist), phentermine-topiramate, naltrexone-bupropion, and orlistat. Of these, tirzepatide has the greatest effect, with mean weight loss of 21% at 72 weeks. Endoscopic procedures (ie, intragastric balloon and endoscopic sleeve gastroplasty) can attain 10% to 13% weight loss at 6 months. Weight loss from metabolic and bariatric surgeries (ie, laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass) ranges from 25% to 30% at 12 months. Maintaining long-term weight loss is difficult, and clinical guidelines support the use of long-term antiobesity medications when weight maintenance is inadequate with lifestyle interventions alone.Conclusion and RelevanceObesity affects approximately 42% of adults in the US. Behavioral interventions can attain approximately 5% to 10% weight loss, GLP-1 agonists and glucose-dependent insulinotropic polypeptide/GLP-1 receptor agonists can attain approximately 8% to 21% weight loss, and bariatric surgery can attain approximately 25% to 30% weight loss. Comprehensive, evidence-based obesity treatment combines behavioral interventions, nutrition, physical activity, pharmacotherapy, and metabolic/bariatric procedures as appropriate for individual patients.

show abstract

AGA Clinical Practice Guideline on Pharmacological Interventions for Adults With Obesity

Cited by 86 publications

References 149 publications

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

¿Podrán los nuevos fármacos frenar la epidemia mundial de la obesidad y el sobrepeso?

Obesity Management in Adults

Contact Info

Product

Resources

About