Beyond lifestyle interventions: exploring the potential of anti-obesity medications in the UK.
John P H WildingPublished in: Clinical obesity (2018)
In the UK, over one-quarter of the adult population have obesity (body mass index ≥30 kg m-2 ). This has major implications for patients' health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services are inconsistently implemented. This may be due primarily to workload and financial constraints. There is also a lack of belief that specialist weight management services and anti-obesity medications (AOMs) are a viable alternative to bariatric surgery for long-term maintenance of weight loss. This article discusses the challenges facing obesity management and explores the reasons for the lack of investment in AOMs in the UK to date. The aim of this article is to identify whether the newer AOMs, such as naltrexone/bupropion and liraglutide 3.0 mg, are likely to perform better in a real-world setting than current or withdrawn AOMs. In addition, it considers whether the equitable provision of specialist weight management services and future clinical trial design could be improved to help identify those individuals most likely to benefit from AOMs and, thus, improve outcomes for people with obesity in the UK.
Keyphrases
- weight loss
- bariatric surgery
- healthcare
- primary care
- roux en y gastric bypass
- weight gain
- gastric bypass
- body mass index
- obese patients
- clinical trial
- glycemic control
- mental health
- palliative care
- metabolic syndrome
- insulin resistance
- public health
- physical activity
- quality improvement
- cross sectional
- affordable care act
- type diabetes
- end stage renal disease
- adipose tissue
- ejection fraction
- high fat diet induced
- health information
- randomized controlled trial
- chronic pain
- health insurance
- cardiovascular disease
- social media
- open label
- current status
- climate change
- double blind
- patient reported outcomes