Author + information
- Received July 22, 2017
- Revision received October 3, 2017
- Accepted November 6, 2017
- Published online January 1, 2018.
- Kishore M. Gadde, MD∗ (, )
- Corby K. Martin, PhD,
- Hans-Rudolf Berthoud, PhD and
- Steven B. Heymsfield, MD
- ↵∗Address for correspondence:
Dr. Kishore M. Gadde, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70810.
Obesity continues to be among the top health concerns across the globe. Despite our failure to contain the high prevalence of obesity, we now have a better understanding of its pathophysiology, and how excess adiposity leads to type 2 diabetes, hypertension, and cardiovascular disease. Lifestyle modification is recommended as the cornerstone of obesity management, but many patients do not achieve long-lasting benefits due to difficulty with adherence as well as physiological and neurohormonal adaptation of the body in response to weight loss. Fortunately, 5 drug therapies—orlistat, lorcaserin, liraglutide, phentermine/topiramate, and naltrexone/bupropion—are available for long-term weight management. Additionally, several medical devices are available for short-term and long-term use. Bariatric surgery yields substantial and sustained weight loss with resolution of type 2 diabetes, although due to the high cost and a small risk of serious complications, it is generally recommended for patients with severe obesity. Benefit-to-risk balance should guide treatment decisions.
Dr. Gadde is an advisor to AstraZeneca with payments made to his employer, Pennington Biomedical Research Center; has received research support from the National Institutes of Health (NIH) and AstraZeneca; and has received speaking honoraria from the American Diabetes Association. Dr. Martin has served as an advisor for ACAP Health, Zafgen, Gila Therapeutics, Weight Watchers, Florida Hospital and Kitchry; has received research funding from the NIH, Centers for Disease Control, U.S. Department of Agriculture, Ohio State University, Elizabeth Blackwell Institute for Health Research, Patient-Centered Outcomes Research Institute, Egg Board, University of Pennsylvania, Louisiana LIFT Fund, Weight Watchers, and Regents of Georgia State University, and Access Business Group International; and has received royalties from his institution licensing smartphone-based technology he invented. Dr. Berthoud has received research funding from the NIH. Dr. Heymsfield has received fees for serving on advisory boards from Janssen Pharmaceuticals, Tanita, Merck, and Medifast.
- Received July 22, 2017.
- Revision received October 3, 2017.
- Accepted November 6, 2017.
- 2018 American College of Cardiology Foundation
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