Obesity consults—comprehensive obesity management in 2013: Understanding the shifting paradigm

Abstract

This continuing medical education activity is sponsored by Collaborative PartnerThis activity is supported by an educational grant fromThe intended audience for this activity is internal medicine physicians, general practice physicians, family practice physicians, endocrinologists, cardiologists, and other healthcare professionals involved in the treatment of obese patients. LEARNING OBJECTIVESAt the conclusion of this series participants should be able to:Examine the link between the pathophysiology of obesity and associated comorbid conditions. Select patients for intervention based on evidence-based criteria and a stepped care approach, which includes diet and lifestyle modifications, pharmacotherapies, and surgery. Incorporate optimal therapeutic regimens for individuals with multiple obesity-related comorbidities.Compare the safety and efficacy profiles of current and emerging anti-obesity medications so that potential risks and benefits are considered when planning treatment. CHIEF MEDICAL EDITOR HOW TO PARTICIPATE IN THIS ACTIVITY AND OBTAIN CME CREDITTo participate in this CME activity, you must read the objectives and articles, complete the CME posttest, and complete and return the registration form and evaluation. Provide only one (1) correct answer for each question. A satisfactory score is defined as answering 70% of the posttest questions correctly. Upon receipt of the completed materials, if a satisfactory score on the posttest is achieved, Vindico Medical Education will issue an AMA PRA Category 1 Credit(s)TM certificate within 4 to 6 weeks. PLANNING COMMITTEE AND FACULTY DISCLOSURESIn accordance with the Accreditation Council for Continuing Medical Education's Standards for Commercial Support, all CME providers are required to disclose to the activity audience the relevant financial relationships of the planners, teachers, and authors involved in the development of CME content. An individual has a relevant financial relationship if he or she has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CME activity content over which the individual has control. Relationship information appears on this page and the next page.

Effectiveness of lifestyle‐based weight loss interventions for adults with type 2 diabetes: a systematic review and meta‐analysis

“…The 10 studies recruited samples ranging from 27 to 5145 participants. The reported mean (range) participant age was 55 (47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60) years. The mean (range) proportion of female participants was 59 (37-100)%, the mean (range) baseline BMI was 35.7 (30.0-38.2) kg/m 2 , and the mean (range) baseline HbA1c was 7.9 (7.3-9.8)%.…”

“…In patients with type 2 diabetes and a BMI ≥27 kg/m 2 the addition of pharmacotherapy could be considered where lifestyle modification alone has been ineffective . Newer diabetes medications, such as glucagon‐like peptide 1 (GLP‐1) receptor agonists, have the advantage of inducing weight loss, in addition to their glucose‐lowering effects, via their action on delaying gastric emptying and increasing satiety, and have been shown to result in weight loss of 1–4 kg .…”

Health Benefits of Long-Term Weight-Loss Maintenance

“…Despite their modest effect on long-term weight loss, lifestyle modifications that include improving eating behaviors and increasing physical activity constitute a cornerstone for integral and sustainable weight management (113). This is mainly because of other weight-independent benefits on health and the synergistic effect of lifestyle modifications on pharmacological and surgical interventions for weight management (225).…”

Do we need race-specific resting metabolic rate prediction equations?

“…Obesity is a serious global health concern due to its association with metabolic and cardiovascular diseases 1 . Weight loss can decrease health risks associated with obesity 2,3 . Primary strategy for weight loss is caloric restriction with addition of pharmaceuticals and/or bariatric surgery when necessary and exercise therapy for weight maintenance 4–7 .…”