Chapter 102: Overweight and Obesity

Content Update

April 30, 2021

FDA Approves Liraglutide (Saxenda) for Chronic Weight Management in Children Ages 12 and Older: In December 2020, the U.S. Food and Drug Administration approved liraglutide (Saxenda), a glucagon-like peptide-1 (GLP-1) receptor agonist, as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in children ages 12 years and older who weigh more than 60 kg (132 lbs) and who are obese, as defined by specific body mass index (BMI) cut-offs for age and sex that correspond to a BMI ≥30 kg/m2 for adults. A phase 3 clinical trial found that liraglutide effectively reduced BMI standard deviation score, BMI, body weight, and waist circumference at week 56 in patients 12 to 17 years old.

Content Update

Feb. 27, 2020

Withdrawal of Lorcaserin (Belviq) from Market: Lorcaserin (Belviq) was voluntarily withdrawn from the market by Eisai, Inc. following a Food and Drug Administration Drug Safety Communication on February 13, 2020 based on the results of the CAMELLIA-TIMI 61 trial. The FDA is not recommending any special screening for patients who have taken lorcaserin.

Content Update

August 12, 2019

Oral, Nonsystemic Hydrogel Approved for Weight Management in Adults: In April 2019, the U.S. Food and Drug Administration (FDA) approved a first-in-class oral, nonsystemic, superabsorbent hydrogel (Plenity) to aid in weight management in overweight and obese adults. The product is classified as a device (not a drug) and was shown to be safe and effective when used in combination with diet and exercise, resulting in significantly greater weight loss vs. placebo in patients with and without type 2 diabetes. The incidence of adverse events in the treatment group was no different from placebo. Plenity is the only prescription product to be approved for weight management in adults with a BMI as low as 25 kg/m², and there is no restriction on its duration of use.

LEARNING OBJECTIVES

Upon completion of the chapter, the reader will be able to:

1. Explain the underlying causes of overweight and obesity.

2. Identify parameters used to diagnose obesity and indicate the severity of disease.

3. Identify desired therapeutic goals for patients with obesity.

4. Recommend appropriate nonpharmacologic and pharmacologic therapeutic interventions for overweight or obese patients.

5. Implement a monitoring plan that will assess both the efficacy and safety of therapy initiated.

6. Educate patients about the disease state and associated risks, comprehensive lifestyle interventions, drug therapy, and surgical options necessary for effective treatment.