Managing obesity related complications with obesity medications

Hi, my name is Andreea Ciudin and I'm an endocrinology specialist and lead of the Vall d’Hebron Collaborating Centers for Obesity Management in Barcelona, Spain.

We all know that obesity is a chronic relapsing disease that drives multiple complications. Today we'll look at how obesity medications can be tailored to specific obesity-related complications based on the latest scientific evidence presented in the Yasso Pharmacological Treatment Algorithm.

Let's get started. Let's begin with type 2 diabetes and prediabetes. Our review found that patients with type 2 diabetes benefit significantly from GLP-1 agonies like semaglutide and dual agonies like T-Hepatitis. The evidence shows that both medications lower HbA1c, promote significant weight reduction, and even lead to diabetes remission in the proportion of patients.

For prediabetes, liraglutide, semaglutide, and T-Hepatitis all increase the chance of restoring rheumoglycemia and reduce progression to diabetes. A practical tip for us is that in patients at high risk of diabetes progression, start with semaglutide or t-HEPA-tide when available. We know that obesity raises cardiovascular risk. Our review indicates that only semaglutide has shown a reduction in major adverse cardiovascular events in patients with established cardiovascular disease. For patients with heart failure, both semaglutide and t-HEPATITE reduce the risk of hospitalization and improve quality of life scores. Practical tip, in patients with obesity and cardiovascular disease, prioritize semaglutide. If heart failure predominates, consider t-HEPATITE or semaglutide.

Our study also reviewed the evidence for liver disease outcomes.

In patients with metabolic-associated dysfunction steatotype liver disease, MASLD, T-Hepatite improves liver enzymes, reduces liver fat, and increases remission rates of steatohepatitis and fibrosis. Semaglutide also reduces liver fat but shows weaker effects on fibrosis. It should be noted that, due to the methodology of our study, the essence trials showing the the effects of semaglutide in mash were not included in this analysis, but the algorithm will be updated and new evidence will be also included. The practical tip now is, if muscle-deodorant mash is present, tirsepatide may be the best first-line pharmacological option. For obstructive sleep apnea, our review shows that tirsepatide is the only medication shown to reduce the apnea-hypopnea index and increase remission rates. Practical tip, in patients with obesity and sleep apnea, tirsepatide should be strongly considered. Obesity can also worsen joint pain. Based on our review of the evidence, semaglutide has demonstrated reduced knee pain and improved function, while liraglutide has not shown consistent benefits. Practical tip, in patients with painful neostar arthritis, semaglutide can offer both weight loss and functional improvement.

Our evidence review also revealed that Orlistat improves cholesterol but is less effective for weight reduction overall. Naltrexone bupropion may benefit more but can increase blood pressure and cures higher risk of adverse events in some patients. Phentermintopyramide promotes weight reduction, but there is a lack of evidence for specific complication improvement. To summarize, obesity medications are not one-size-fits-all. As healthcare professionals, tailoring obesity medication to the patient's primary complication allows us to move beyond weight loss and directly improve health outcomes.

I am Andreea Ciudin for 5-Minute CPD. Thanks for watching. Be sure to check out additional resources on this page and more learning at easo.org.