Characterizing Existing Therapies for Weight Loss in Patients With Obesity

The amount of weight lost varies widely across treatments intended to reduce weight in patients with obesity, according to research published in Diabetes, Obesity and Metabolism.

Researchers reviewed existing literature to evaluate weight loss outcomes in relation to lifestyle, diet, medications, and surgical treatments. Focus questions included: (1) How much weight loss is needed to benefit patients with obesity? (2) How well do current therapies do in producing weight loss? and (3) What strategies can be used to improve patient outcomes using evidence-based studies?

During a review of related literature, the researchers discovered the following key findings:

• lifestyle, diet, and exercise changes result in an average of 5% to 7% weight loss;
• low carbohydrate diets have not demonstrated significant weight loss compared to low fat diets;
• two investigational medications, semaglutide and tirzepatide, significantly improve the average 5% weight loss benefit that currently approved medications produce when combined with lifestyle changes; and
• no evidence exists to suggest the efficacy of individualizing treatment approaches based on patient genotype or phenotype.

Additionally, data shows that bariatric surgery is more effective than the currently four weight loss drugs currently approved by the US Food and Drug Administration. However, the decision to pursue surgery or employ a medication for weight loss is always based on individual health risk assessment.

“Because obesity is a chronic disease it requires a continuous treatment model across the lifespan,” researchers noted. “For patients with more comorbidities, treatments that produce more weight loss are indicated.”

Reference:
Bray GA, Ryan DH. Evidence-based weight loss interventions: Individualized treatment options to maximize patient outcomes [published online ahead of print November 24, 2020]. Diabetes Obes Metab. 2021 Feb;23 Suppl 1:50-62. doi:10.1111/dom.14200