Guide Lines

New Guidance on Obesity Drugs

Drugs can have a profound effect on the health of people with obesity — for better or for worse. When the long process to develop new obesity treatment guidelines in 2013 did not include anything about drugs, a sigh of disappointment was audible. So the brand new publication of guidance on obesity drugs by the Endocrine Society was welcome news yesterday.

The recommendations are not revolutionary. They represent solid clinical guidance incorporated into every obesity medicine physician’s clinical practices. But they provide a foundation for better practices by primary care physicians who continue to care for most people with excess weight and obesity.

A total of 18 clinical recommendations are divided into two sections: routine care of people with excess weight and obesity, and alternatives to drugs that commonly cause weight gain. A final recommendation is to avoid use of drugs for chronic obesity management that are not specifically indicated for obesity.

Boston University Professor Caroline Apovian led the process and commented on the guidelines, saying:

Lifestyle changes should always be a central part of any weight loss strategy. Medications do not work by themselves, but they can help people maintain a healthy diet by reducing the appetite. Adding a medication to a lifestyle modification program is likely to result in greater weight loss.

Donna Ryan, a past president of the Obesity Society and lead author of the 2013 guidelines, said that the Obesity Society fully endorses these guidelines, which shift the treatment paradigm from considering weight last, to considering it first in people with obesity.

The perspective on using obesity medications for better outcomes is certainly helpful. Perhaps as important is the identification of medications to avoid in people with obesity because they can cause further weight gain.

First do no harm.

Click here to read the new guidelines.

Guide Lines, photograph © iamdat / flickr

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