Fundamentals of cardiometabolic risk factor reduction: achieving and maintaining weight loss with pharmacotherapy or bariatric surgery.
Obesity is a major health problem in the United States and many other countries because of its high prevalence and causal relationship with serious medical comorbidities. The therapeutic options currently available to help obese patients lose weight are: (1) therapeutic lifestyle change (behavioral, dietary, and physical activity modification); (2) pharmacotherapy; and (3) bariatric surgery. Lifestyle modification is the first therapeutic choice; however, achieving a successful long-term weight loss with lifestyle intervention alone is difficult. There is increasing interest, therefore, in the use of pharmacotherapy and surgery to treat obesity. Although there are a number of antiobesity medications available, the only medications approved in the United States for long-term treatment of obesity are sibutramine and orlistat. Use of these medications results in 3% to 5% more weight loss compared with placebo after 1 year. Bariatric surgery is an effective weight loss option for obese patients, but it is restricted to patients who are considered morbidly obese (ie, with a body mass index [BMI] > or =40 kg/m(2) or a BMI of 35-39.9 kg/m(2) with > or =1 severe obesity-related medical complication).
Fabbrini
Elisa
E
Center for Human Nutrition, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Klein
Samuel
S
D019440:Anti-Obesity Agents / Q000627:therapeutic use*; D050110:Bariatric Surgery; D063385:Cannabinoid Receptor Modulators / Q000037:antagonists & inhibitors; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003503:Cyclobutanes / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D006801:Humans; D007783:Lactones / Q000627:therapeutic use; D009765:Obesity / Q000628:therapy*; D000077403:Orlistat; D012307:Risk Factors; D015431:Weight Loss
D019440:Anti-Obesity Agents; D063385:Cannabinoid Receptor Modulators; D003503:Cyclobutanes; D007783:Lactones; D000077403:Orlistat; C058254:sibutramine