July, 2020
- Candidates for weight loss are people who are either: 1) obese (BMI ? 30 kg/m2); or 2) overweight (BMI ? 25 kg/m2) with coexisting conditions related to obesity (eg, sleep apnea, osteoarthritis) or certain cardiovascular risk factors (eg, prediabetes or waist circumference > 40 inches for men and > 35 inches for non-pregnant women).
- People who gradually lose 1-2 pounds per week for 6 months have a higher chance of successfully keeping weight off. When people lose weight, there are improvements in cardiometabolic risk factors (eg, waist circumference, diabetes parameters, blood pressure, triglycerides, HDL cholesterol).
- FDA-approved weight loss medications can be effective when combined with lifestyle modifications (eg, diet,
- physical activity).
- Phentermine/topiramate (Qysmia ) provides dose dependent weight loss compared to diet and exercise alone. In a large 56-week trial, individuals lost 18 to 22.5 lb with phentermine/ topiramate compared to 3 lb for those who took placebo.
- In several year-long trials, patients taking naltrexone/bupropion (Contrave ) lost an average of 3.7-8.1% of body weight; those taking placebo lost 1.7-4.9% of body weight.
- In a large 56-week trial of liragutide (Saxenda ) in overweight or obese patients, 63% of patients on liraglutide lost at least 5% ot their body weight, compared to 27% of those taking placebo.
- Several types of prescription medications can cause weight gain; it is important for healthcare providers to identify these drugs and provide alternatives when possible.
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