Obesity: Which Drug and When?
Background: Obesity, with all its consequences, is audaciously confronting medical professionals and health service providers worldwide. Diet and exercise intervention is an essential part of any weight management strategy, but may not succeed in isolation. Effective approaches for routine practice are more likely to involve affordable, efficacious and well-tolerated drug therapy than the more expensive, case selective approach of bariatric surgery.
Objectives and Conclusions: Advancement of pharmacotherapy is expanding the battery of available drugs; the clinician is faced with an increasingly complex therapeutic decision. Which drug to use, and when, is influenced by a range of factors, discussed here. There is a large body of high quality evidence in the literature to support the presently available drugs; however, many questions remain unanswered including duration of therapy and whether longer-term goals of improved morbidity and mortality are achievable. Clinician and patient awareness of these issues will provide a more informed therapeutic decision and ultimately improve the potential for reaching the weight management targets.
The Obesity Epidemic. Present trends predict that by 2010, one-third of adults in the UK will be obese . Obesogenic traits of westernised society had reached every corner of the globe and the problem has reached pandemic proportions. Worldwide, the World Health Organisation indicates that there were at least 400 million obese adults in 2005; by 2015, this will have almost doubled to 700 million. The nature of global malnutrition is changing with as many people now suffering from overnutrition as those under-nourished. The costs to society are incalculable. Rising levels of comorbidity affecting nearly every organ system in the body have outstripped improvements brought about by advances in public health and medical care and declining smoking rates, potentially causing a decrease in life expectancy in developed countries for the first time.
Background: Obesity, with all its consequences, is audaciously confronting medical professionals and health service providers worldwide. Diet and exercise intervention is an essential part of any weight management strategy, but may not succeed in isolation. Effective approaches for routine practice are more likely to involve affordable, efficacious and well-tolerated drug therapy than the more expensive, case selective approach of bariatric surgery.
Objectives and Conclusions: Advancement of pharmacotherapy is expanding the battery of available drugs; the clinician is faced with an increasingly complex therapeutic decision. Which drug to use, and when, is influenced by a range of factors, discussed here. There is a large body of high quality evidence in the literature to support the presently available drugs; however, many questions remain unanswered including duration of therapy and whether longer-term goals of improved morbidity and mortality are achievable. Clinician and patient awareness of these issues will provide a more informed therapeutic decision and ultimately improve the potential for reaching the weight management targets.
The Obesity Epidemic. Present trends predict that by 2010, one-third of adults in the UK will be obese . Obesogenic traits of westernised society had reached every corner of the globe and the problem has reached pandemic proportions. Worldwide, the World Health Organisation indicates that there were at least 400 million obese adults in 2005; by 2015, this will have almost doubled to 700 million. The nature of global malnutrition is changing with as many people now suffering from overnutrition as those under-nourished. The costs to society are incalculable. Rising levels of comorbidity affecting nearly every organ system in the body have outstripped improvements brought about by advances in public health and medical care and declining smoking rates, potentially causing a decrease in life expectancy in developed countries for the first time.