title: New tools for weight-loss therapy enable a more robust medical model for obesity treatment: rationale for a complications-centric approach.
abstract: OBJECTIVE
  Recent advances in lifestyle intervention programs, pharmacotherapy, and bariatric surgery have enabled the development of medical models for the treatment of obesity. Regarding pharmacotherapy, in 2012 the U.S. Food and Drug Administration approved two new effective and safe weight-loss medications, phentermine/topiramate extended release and lorcaserin, which has greatly augmented options for medically assisted weight loss.
  
  
  METHODS
  The rationale for advantages of a complications-centric medical model over current body mass index (BMI)-centric indications for therapy is examined.
  
  
  RESULTS
  Currently, the baseline BMI level is the principle determinant of indications for obesity treatment using medication and surgery. However, the BMI-centric approach fails to target therapy to those obese patients who will benefit most from weight loss. In contrast, a complications-centric medical model is proposed that will earmark the modality and intensity of the therapeutic intervention based on the presence and severity of complications that can be ameliorated by weight loss.
  
  
  CONCLUSIONS
  The complications-centric approach to "medicalizing" obesity care employs weight loss primarily as a tool to treat obesity-related complications and promotes the optimization of health outcomes, the benefit/risk ratio, and the cost-effectiveness of therapy.
authors.affiliation: Department of Nutrition Sciences, University of Alabama at Birmingham, and the Birmingham VA Medical Center, Birmingham, Alabama.
authors.forename: W Timothy
authors.initials: WT
authors.lastname: Garvey
mesh_terms: D019440:Anti-Obesity Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000188:drug therapy* / Q000628:therapy; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology
chemical_list: D019440:Anti-Obesity Agents