Refractory and Resistant obesity: Dynamic Concepts, Contemporary Definitions
Sanjay Kalra1, Saurabh Arora2, Nitin Kapoor3
1Department of Endocrinology, Bharti Hospital, Karnal.
JPMA. the Journal of the Pakistan Medical Association
|February 26, 2023
Summary
This study addresses resistant obesity, defining a framework to evaluate treatment effectiveness and identify underlying causes for better patient management. It aids clinicians in assessing outcomes and guides research for policy development.
Area of Science:
- Obesity Medicine
- Metabolic Disorders
- Clinical Therapeutics
Background:
- Obesity is a complex chronic disease requiring comprehensive management.
- Current therapies, including glucagon-like peptide-1 receptor agonists (GLP-1RAs) and bariatric surgery, are effective but not universally successful.
- A subset of patients exhibits resistance or refractoriness to established treatments.
Purpose of the Study:
- To introduce and define the concepts of resistant and refractory obesity.
- To provide a practical framework for clinicians to assess treatment adequacy.
- To guide the identification of non-adherence and non-adiposity-related causes of weight gain.
Main Methods:
- Literature review and conceptual framework development.
- Analysis of therapeutic outcomes in obesity management.
- Identification of factors contributing to suboptimal weight loss.
Main Results:
- Defines resistant obesity as a failure to achieve desired outcomes despite optimal therapy.
- Proposes an operational framework for evaluating treatment efficacy and adherence.
- Highlights the need to consider iatrogenic and non-adiposity-related factors in weight management.
Conclusions:
- A structured approach is needed to manage patients with resistant or refractory obesity.
- The proposed framework can improve clinical assessment and treatment planning.
- Clarifying these concepts will advance research and inform health policy for obesity care.
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