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Obesity Treatment Guidance

Obesity Treatment Guidance

Professional associations around the world recommend comprehensive treatment of obesity1-3

Successfully treating obesity requires a comprehensive, individualized long-term plan2,3

  • Obesity Medicine Association
    Management and treatment of obesity require a multifaceted, patient-centered, individual approach4

  • European Association for the Study of Obesity
    Physicians have a responsibility to recognize obesity as a disease and help adults with obesity with appropriate prevention and treatment1

  • Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons
    People with obesity need access to evidence-informed interventions, including medical nutrition therapy, physical activity, psychological interventions, pharmacotherapy, and surgery2

BMI
≥25 kg/m2		BMI
≥27 kg/m2		BMI
≥30 kg/m2		BMI
≥35 kg/m2		BMI
≥40 kg/m2
Surgery
With
obesity-related
complications
✔
Pharmacotherapy
With
obesity-related
complications
✔✔✔
Psychological and behavioral interventions✔✔✔✔✔

All individuals, regardless of body size or composition, benefit from a healthy, well-balanced eating pattern and regular physical activity.

Note: Adapted from Obesity Medicine Association4, European Association for the Study of Obesity1 and Obesity Canada and the Canadian Association of Bariatric Physicians and Surgeons2.

  1. Yumuk V, Tsigos C, Fried M, et al. European guidelines for obesity management in adults. Obes Facts. 2015;8(6):402-424. doi:10.1159/000442721

  2. Wharton S, Lau DCW, Vallis M, et al. Obesity in adults: a clinical practice guideline. CMAJ. 2020;192(31):E875-E891. doi:10.1503/cmaj.191707

  3. Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Med Clin North Am. 2018;102(1):183-197. doi:10.1016/j.mcna.2017.08.012

  4. Fitch AK, Bays HE. Obesity definition, diagnosis, bias, standard operating procedures (SOPs), and telehealth: an Obesity Medicine Association (OMA) clinical practice

Benefits of Treating Obesity

Prioritizing treatment of obesity may change the paradigm for addressing its complications1

ObesityT2DHTNCVD
Cardiometabolic targetsWeight and WCHbA1cSBP and DBPLDL Cholesterol
Key complications
  • T2D
  • HTN
  • MASLD/MASH
  • CVD
  • CKD
  • OSA
  • OA
  • CKD
  • Retinopathy
  • Neuropathy
  • CVD
  • CHF
  • Stroke
  • CKD
  • MI
  • Stroke
  • Amputation

BMI=body mass index; BP=blood pressure; CHF=congestive heart failure; CKD=chronic kidney disease; CVD=cardiovascular disease; DBP=diastolic blood pressure; HDL=high-density lipoprotein; HTN=hypertension; LDL=low-density lipoprotein; MASH=metabolic dysfunction-associated steatohepatitis; MASLD= metabolic dysfunction-associated steatotic liver disease; MI=myocardial infarction; OA=osteoarthritis; OSA=obstructive sleep apnea; SBP=systolic blood pressure; TG=triglyceride; WC=waist circumference.

Weight loss of ≥5% to ≥15% improves many obesity-related complications1-4

Lady with handbag
Weight LossImproved Outcomes
≥ 5 %
  • Lipids (TG, HDL)
  • Hypertension
  • Glycemic control
  • Risk of type 2 diabetes (T2D)
≥ 10 %
  • Osteoarthritis
  • Gastroesophageal reflux disease
  • Steatohepatitis
  • Obstructive sleep apnea
  • Risk of cardiovascular death
≥ 15 %
  • Mortality
  • Remission of T2D

HDL=high-density lipoprotein; TG=triglyceride.

People with overweight or obesity should be screened for complications such as prediabetes, type 2 diabetes, dyslipidemia, hypertension, metabolic syndrome, cardiovascular disease, metabolic dysfunction-associated steatotic liver disease, osteoarthritis, and depression.5

Start your patients on the path to successful treatment for obesity

  1. Garvey WT. New horizons. A new paradigm for treating to target with second-generation obesity medications. J Clin Endocrinol Metab. 2022;107(4):e1339-e1347. doi:10.1210/clinem/dgab848

  2. Cefalu WT, Bray GA, Home PD, et al. Advances in the science, treatment, and prevention of the disease of obesity: reflections from a diabetes care editors’ expert forum. Diabetes Care. 2015;38(8):1567-1582. doi:10.2337/dc15-1081

  3. Horn DB, Almandoz JP, Look M. What is clinically relevant weight loss for your patients and how can it be achieved? A narrative review. Postgrad Med. 2022;134(4):359-375. doi:10.1080/00325481.2022.2051366

  4. Ryan DH, Yockey SR. Weight loss and improvement in comorbidity: differences at 5%, 10%, 15%, and over. Curr Obes Rep. 2017;6(2):187-194. doi:10.1007/s13679-017-0262-y

  5. Garvey WT, Mechanick JI, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22(suppl 3):1-203. doi:10.4158/EP161365.GL