The first-ever clinical practice guideline for the drug treatment of obesity offers a new tool for health practitioners looking to the latest pharmacotherapy strategies as a means of treating patients with obesity. The release comes on the heels of U.S. Food and Drug Administration (FDA) approval of four new anti-obesity drugs in the past two years — lorcaserin (Belviq), phentermine/topiramate (Qsymia), naltrexone/bupropion (Contrave) and liraglutide (Saxenda). The guideline, “Pharmacological Management of Obesity: An Endocrine Society Clinical Practice Guideline,” is published by the Endocrine Society, with support from The Obesity Society (TOS) and the European Society of Endocrinology.
“The pharmacotherapy guideline provides a roadmap for clinicians considering anti-obesity drug treatment for patients not finding success with diet and exercise alone,” says Donna Ryan, MD, member of the development panel and professor emeritus at Louisiana State University’s Pennington Biomedical Research Center, speaking on behalf of TOS. “The new guideline provides doctors with recommended medications and dosage based on obesity-related comorbidities, including type 2 diabetes and cardiovascular disease. Further, it gives specific recommendations for transitioning patients off drugs that cause weight gain, shifting the treatment paradigm from treating weight last, to treating weight first.”
The Endocrine Society further highlights key recommendations from the guideline, including: implications for continuing and discontinuing medication, guidance for prescribing medications that promote weight loss or have no effect on weight, and disclosure of information about medication-related weight gain to patients to promote shared decision making.
As the first pharmacotherapy guideline for the treatment of obesity, the new resource expands upon the “Guidelines (2013) for Managing Overweight and Obesity in Adults,” published in Obesity in November 2013 by TOS, the American Heart Association (AHA) and the American College of Cardiology (ACC).
“The 2013 Guidelines help health practitioners identify patients who may benefit from pharmacotherapy, and the new pharmacological guideline can help them decide on the best anti-obesity drug option,” continued Dr. Ryan. “Combined, both resources fill a gap in the treatment of obesity, a disease that puts individuals at risk for more than 30 other health conditions, including type 2 diabetes and cardiovascular disease.”
Seeking the support of a healthcare practitioner for weight loss can make all the difference for people affected by obesity. As an adjunct to diet and exercise, medications approved by the FDA for the treatment of obesity can help those affected to lose weight, specifically if they have not found prior success with diet and exercise alone. Taken together, both guidelines provide an evidence-based tool to help physicians identify and treat patients struggling with their weight that may need the additional support.
“We call on prescribing health practitioners from primary care physicians to bariatric surgeons to review both guidelines and take steps to put them into practice,” concludes Dr. Ryan. “Broad, sweeping transformations in obesity management in the primary care setting can help identify patients most in need of this additional support.
