Anti-Obesity Pharmacotherapy for Long-Term Obesity Management



Dr. Carolyn T. Bramante, MD, MPH presented a grand round on Anti-Obesity Pharmacotherapy for Long-Term Obesity Management. She discussed the complexity of obesity as a disease, the physiological and genetic factors affecting it, the importance of individualizing treatment, and the effectiveness of various medications. Dr. Bramante also shared a patient example of successful weight loss in preparation for a lung transplant. She emphasized the need for frequent follow-up, individualized treatment plans, and the potential for weaning off medications after reaching target weight loss goals.

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Key Takeaways:
  • Dr. Bramante is an assistant professor at the University of Minnesota specializing in Obesity management and remotely delivered interventions.
  • Obesity is a complex, multifactorial disease with societal and genetic influences.
  • Prevalence of obesity varies by ethnicity and region, with a significant impact on health disparities.
  • Obesity stigma affects individuals throughout their interactions with the healthcare system.
  • Physiological responses to weight loss show hormonal changes that promote weight regain.
  • Pillars of obesity treatment include behavioral changes, reduced calorie diet, increased physical activity, stress reduction, sleep, and medication management.
  • Medications for obesity include terzapatide, liraglutide, phentermine/topiramate, and metformin, each with its own efficacy and side effect profile.
  • Avoiding weight-gain promoting medications is important, especially in patients with obesity.
  • Bariatric surgery and endoscopic treatment options are also available for severe cases of obesity.
  • Individualized treatment plans, frequent follow-up, and the potential for weaning off medications after reaching weight loss goals are essential in obesity management.
 

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A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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