Obesity treatment in adolescents and adults in the era of personalized medicine.
Magnus SundbomKajsa JärvholmLovisa SjögrenPaulina NowickaYlva Trolle LagerrosPublished in: Journal of internal medicine (2024)
In this multi-professional review, we will provide the in-depth knowledge required to work in the expanding field of obesity treatment. The prevalence of obesity has doubled in adults and quadrupled in children over the last three decades. The most common treatment offered has been lifestyle treatment, which has a modest or little long-term effect. Recently, several new treatment options-leading to improved weight loss-have become available. However, long-term care is not only about weight loss but also aims to improve health and wellbeing overall. In the era of personalized medicine, we have an obligation to tailor the treatment in close dialogue with our patients. The main focus of this review is new pharmacological treatments and modern metabolic surgery, with practical guidance on what to consider when selecting and guiding the patients and what to include in the follow-up care. Furthermore, we discuss common clinical challenges, such as patients with concurrent eating disorder or mental health problems, and treatment in the older adults. We also provide recommendations on how to deal with obesity in a non-stigmatizing way to diminish weight stigma during treatment. Finally, we present six microcases-obesity treatment for persons with neuropsychiatric disorders and/or intellectual disability; obesity treatment in the nonresponsive patient who has "tried everything"; and hypoglycemia, abdominal pain, and weight regain after metabolic surgery-to highlight common problems in weight-loss treatment and provide personalized treatment suggestions.
Keyphrases
- weight loss
- mental health
- type diabetes
- metabolic syndrome
- insulin resistance
- healthcare
- young adults
- intellectual disability
- minimally invasive
- end stage renal disease
- physical activity
- bariatric surgery
- body mass index
- cardiovascular disease
- chronic kidney disease
- autism spectrum disorder
- squamous cell carcinoma
- skeletal muscle
- acute coronary syndrome
- roux en y gastric bypass
- ejection fraction
- newly diagnosed
- climate change
- risk assessment
- health information
- peritoneal dialysis
- social media