title: A review of unmet needs in obesity management.
abstract: The prevalence of obesity continues to escalate in the USA; however, there is no consensus regarding the optimal therapy for obesity. For the vast majority of severely obese patients, conventional medical therapies (i.e., diet, exercise, behavioral counseling) often fail over the long term. Existing pharmacotherapy adjunctive to behavioral therapy has limited effectiveness and an imperfect safety record. In contrast, bariatric surgery has a high degree of weight loss efficacy, yet only a small fraction of the qualifying obese population undergoes these procedures because of the associated perioperative risks and potential late complications. In addition, the role of bariatric surgery is unclear in certain patient populations, such as patients with lower body mass index (BMI, 30-35 kg/m(2)), the high-risk super-super obese patients (BMI > 60), the morbidly obese adolescent, and obese patients requiring weight reduction in preparation for other procedures, such as orthopedic, transplant, or vascular surgeries. In these circumstances, there is a need for an effective but less invasive treatment to bridge the gap between medical and surgical therapy. This review examines current treatment outcomes, identifies prominent areas of unmet clinical needs, and provides an overview of two minimally invasive "temporary procedures for weight loss" that may eventually address some of the unmet needs in obesity management.
authors.affiliation: Division of GI Surgery, University of California Irvine Medical Center, 333 City Bldg. West, Suite 850, Orange, CA 92868, USA. ninhn@uci.edu
authors.forename: N
authors.initials: N
authors.lastname: Nguyen
authors.forename: J K
authors.initials: JK
authors.lastname: Champion
authors.forename: J
authors.initials: J
authors.lastname: Ponce
authors.forename: B
authors.initials: B
authors.lastname: Quebbemann
authors.forename: E
authors.initials: E
authors.lastname: Patterson
authors.forename: B
authors.initials: B
authors.lastname: Pham
authors.forename: W
authors.initials: W
authors.lastname: Raum
authors.forename: J N
authors.initials: JN
authors.lastname: Buchwald
authors.forename: G
authors.initials: G
authors.lastname: Segato
authors.forename: F
authors.initials: F
authors.lastname: Favretti
mesh_terms: D019440:Anti-Obesity Agents / Q000627:therapeutic use; D001067:Appetite Depressants / Q000627:therapeutic use; D001521:Behavior Therapy / Q000379:methods* / Q000639:trends; D015992:Body Mass Index; D015444:Exercise; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D015438:Health Behavior; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009767:Obesity, Morbid / Q000188:drug therapy / Q000534:rehabilitation* / Q000601:surgery; D014481:United States / Q000453:epidemiology
chemical_list: D019440:Anti-Obesity Agents; D001067:Appetite Depressants