Management of Obesity: Review of Adjunctive Therapies and Clinical Management Pearls.

Abstract

Obesity remains one of the most prevalent costly diseases in the US and across the world. New therapies are available to treat obesity, and more therapies are in the pipeline. While lifestyle therapy by itself achieves only modest weight loss, the new generation anti-obesity medications, endoscopic bariatric and metabolic therapies and bariatric surgeries are highly effective at treating obesity. Despite these therapies, the rate of obesity in the US has remained stable. Multiple factors likely contribute to inadequate obesity treatment in the US including cost and insufficient insurance coverage, but lack of access to care due to insufficient numbers of providers prescribing anti-obesity medications or performing endoscopic or surgical procedures would remain a problem even with improved insurance coverage. Although most gastroenterologists do not have specific obesity training, they are in a unique position to help fill this void as the most effective obesity therapies are gut or gut hormone directed. This manuscript outlines the current obesity treatments, future therapies on the horizon, and clinical pearls for managing patients with obesity management medications, endoscopic bariatric and metabolic therapies, and bariatric and metabolic surgery.