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Obesity

Obesity

The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...

Drug Dosing: Obese Patients

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion

Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...

Diabetes: Management and Pharmacotherapy

Diabetes: Management and Pharmacotherapy

The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...

Insulin: Dosing Regimen and Adverse Effects

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...

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Corrigendum to "Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society [Obesity Pillars 15 (2025) 100181].

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Multidisciplinary Approach to Obesity Management: A Case Report

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Published on: May 30, 2025

Attitudes, Perceptions, and Practices Among Endocrinologists Managing Obesity.

Monica Agarwal¹, Karl Nadolsky²

¹Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, Alabama.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

|November 8, 2021

Summary

Most endocrinologists recognize obesity as a disease, but many lack familiarity with advanced treatments and resources. Enhancing clinician awareness and education is crucial for improving obesity management through a multimodal approach.

Keywords:

antiobesity medications endocrinologists obesity obesity medicine specialists

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Area of Science:

Endocrinology
Metabolic Diseases
Public Health

Background:

Obesity is a globally recognized disease by major health organizations.
Despite recognition, healthcare systems and the public have been slow to fully embrace this concept.
Endocrinologists play a key role in managing obesity, yet their perspectives on its treatment and related challenges are vital.

Purpose of the Study:

To survey endocrinologists regarding their awareness, practices, and perceived barriers in managing obesity.
To assess the adoption of various obesity treatment modalities, including medications and surgical interventions.
To identify knowledge gaps and areas for improvement in clinical practice for obesity management.

Main Methods:

A survey was developed by the American Association of Clinical Endocrinology and reviewed by endocrinologists.
The survey covered demographics, obesity awareness, treatment methods, barriers, digital health, and social determinants of health.
The survey was distributed to 493 endocrinologists, with 305 (62%) completing the study.

Main Results:

98% of respondents agreed that obesity is a disease.
53% were familiar with "adiposity-based chronic disease"; 13% were certified by the American Board of Obesity Medicine.
While most recommended lifestyle changes, fewer prescribed anti-obesity medications or referred for bariatric surgery; certified endocrinologists favored a multidisciplinary approach.

Conclusions:

Self-reported data reveal the need for a multimodal approach to obesity care.
Increased clinician awareness, identification of knowledge gaps, and targeted educational tools are necessary.
Fostering collaboration among healthcare professionals is essential for improving obesity outcomes.