Obesity Therapeutics (Dr.Ezzo)

Background info.

Obesity Classifications

Class 1: BMI 30 to < 35

Class 2: BMI 35 to <40

Class 3: BMI ≥ 40

Risk factors of Obesity

- Genetics (leptin mutation)

- Medications

- Environmental

- Medical Conditions (Hypothyroidism, depression)

- Socioeconomic factors

- Age

- Lifestyle factors

List the medications that cause Weight gain

- Antidepressants

- Birth control

- Beta blockers

- Glucocorticoids

- Sulfonylurea

Non-pharmacological treatment

List Non-pharmacological treatment

- Nutrition & Diet

- Physical activity

- Behavioral modification

- Treat underlying condition

- Survey

Primary treatment for Children and Geriatric:

Lifestyle interventions

List Lifestyle interventions for Obesity (2)

- Calorie deficit of 500-750 kcal/day

- 150 minutes of physical activity

Explain Physical activity

- 150 minute of physical activity

- Aerobic exercise 3-5 days a week

- Resistance training 2-3 days a week

Pharmacological Therapy

When should you initiate pharmacotherapy for obesity (2)

- BMI ≥ 30

- BMI ≥ 27 + weight related complications

[weight related complications = lifestyle intervention did not work]

1st in line pharmacotherapy for Obesity

- Semaglutide

- Tirzepatide

- Liraglutide

[^GLP/GLP-1/GIP agonist^]

Monitoring of GLP/GLP-1/GIP agonist

BP

GLP/GLP-1/GIP agonist can cause a increase of _____

hypoglycemia in DM pts.

Which patient specific population should use GLP/GLP-1/GIP agonis with caution:

• Bulimia nervosa - medications are not to be used

• Binge eating disorder - monitor for worsening of behaviors

Common side effects of GLP/GLP-1/GIP agonist

N/V/D/C

Treatment of N/V in patients due taking GLP-1/GIP agonist

Short term antiemetics (Ondansetron)

Treatment of Dyspepsia in patients taking GLP-1/GIP agonist

PPI or H2 blockers

Treatment of Constipation in patients taking GLP-1/GIP agonist

- Increase fiber intake & hydration

- Bulk-forming laxative or Stool softeners or Osmotic agents