Endocrine Abstracts (2011) 26 MTE12

Treatment strategies for obesity

Dragan Micc


Clinic for Endocrinology, Diabetes and Disease of Metabolism, Clical Center of Serbia, Belgrade, Serbia.


Overweight and obesity have become an increasingly serious clinical and socioeconomic problem worldwide. Recent systematic analysis of health examination surveys demonstrated that in 2008 an estimated 1.46 billion adults worldwide had BMI of 25 kg/m2 or greater, of these 205 million men and 297 million women were obese. Overweight and obese patients are at increased risk for developing various co-morbidities (type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, obstructive sleep apnea, hepatobiliary disease and certain cancers). The goals of treatment strategies for overweight and obesity are to reduce body weight and to maintain lower body weight over the long term. Patient should understand that, since obesity is a chronic disease, weight management will need to be lifelong. In some patients, especially in those with overweight, prevention of further weight gain rather than weight loss per se may be appropriate target. Specific components of treatment for obesity are: diet, cognitive behavioural approaches, physical activity, psychological support, pharmacological treatment and surgery. Current drug therapy is recommended for patients with a BMI≥30.0 kg/m2 or a BMI≥27 with an obesity-related disease (such as hypertension, type 2 diabetes). The major groups of anti-obesity drugs are: centrally acting medications that impair dietary intake; medications that act peripherally to impair dietary absorption, and medications that increase energy expenditure. Currently, Orlistat is is the only FDA-approved antiobesity drug on the market. Surgery should be considered for patients from 18–60 years of age with BMI≥40.0 or with BMI between 35.0 and 39.9 kg/m2 and co-morbidities in whom surgically induced weight loss is expected to improve the disorder (type 2 diabetes, cardiorespiratory disease, severe joint disease and obesity-related severe psychological problems) (according EASO European Clinical Practice Guidelines for Management of Obesity).

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