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Pharmacological management of obesity: an endocrine Society clinical practice guideline
Caroline M Apovian1, Louis J Aronne, Daniel H Bessesen
1Boston University School of Medicine and Boston Medical Center (C.M.A.), Boston, Massachusetts 02118; Weill-Cornell Medical College (L.J.A.), New York, New York 10065; Denver Health Medical Center (D.H.B.), Denver, Colorado 80204; Brigham and Women's Hospital (M.E.M.), Boston, Massachusetts 02115; Mayo Clinic, Division of Preventative Medicine (M.H.M.), Rochester, Minnesota 55905; Alma Mater University of Bologna (U.P.), S. Orsola-Malpighi Hospital Endocrinology Unit, 40138 Bologna, Italy; Pennington Biomedical Research Center (D.H.R.), Baton Rouge, Louisiana 70808; and Geisinger Health Care System (C.D.S.), Danville, Pennsylvania 17822.
Objective:
To formulate clinical practice guidelines for the pharmacological management of obesity.
Participants:
An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer. This guideline was co-sponsored by the European Society of Endocrinology and The Obesity Society.
Evidence:
This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence.
Consensus Process:
One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of the Endocrine Society, the European Society of Endocrinology, and The Obesity Society reviewed and commented on preliminary drafts of these guidelines. Two systematic reviews were conducted to summarize some of the supporting evidence.
Conclusions:
Weight loss is a pathway to health improvement for patients with obesity-associated risk factors and comorbidities. Medications approved for chronic weight management can be useful adjuncts to lifestyle change for patients who have been unsuccessful with diet and exercise alone. Many medications commonly prescribed for diabetes, depression, and other chronic diseases have weight effects, either to promote weight gain or produce weight loss. Knowledgeable prescribing of medications, choosing whenever possible those with favorable weight profiles, can aid in the prevention and management of obesity and thus improve health.
