Advertisement

Medically Supervised Weight Loss Programs

  • Ricard Corcelles
  • Bartolome Burguera
Chapter

Abstract

Obesity is a multifactorial chronic disease affecting nearly 60 million adult Americans. Anti-obesity medications may have an important role in helping people to lose weight in the context of a lifestyle intervention program. Pharmacotherapy has shown to improve metabolic control in patients with obesity and type 2 diabetes (T2D). Due to scarce accessibility to surgery for all patients with severe obesity, there is a need for medical treatment options. Thus, it is necessary to develop effective multidisciplinary medical therapies alternative and complementary to bariatric surgery. In this chapter, we describe the role of anti-obesity drugs to treat obesity and T2D.

Keywords

Morbid obesity Anti-obesity medications Pharmacotherapy Lifestyle intervention Weight loss Adverse effects 

Abbreviations

BID

Two times a day

BMI

Body mass index

CAD

Coronary artery disease

CHF

Congestive heart failure

ECG

Electrocardiogram

EMA

European medicines agency

FDA

Food and drug administration

GLP-1

Glucagon-like peptide 1

HTN

Hypertension

IGT

Impaired glucose tolerance

QD

Once a day

T2D

Type 2 diabetes

References

  1. 1.
    Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491.CrossRefPubMedGoogle Scholar
  2. 2.
    Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief. 2015;219:1–8.Google Scholar
  3. 3.
    Magkos F, Fraterrigo G, Yoshino J, Luecking C, Kirbach K, Kelly S, et al. Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity. Cell Metab. 2016;23(4):591–601.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Wing RR, Lang W, Wadden TA, Safford M, Knowler WC, Bertoni AG, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481–6.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Wadden TA, Berkowitz RI, Sarwer DB, Prus-Wisniewski R, Steinberg C. Benefits of lifestyle modification in the pharmacologic treatment of obesity: a randomized trial. Arch Intern Med. 2001;161(2):218–27.CrossRefPubMedGoogle Scholar
  6. 6.
    Tur JJ, Escudero AJ, Alos MM, Salinas R, Terés E, Soriano JB, et al. One year weight loss in the TRAMOMTANA study. A randomized controlled trial. Clin Endocrinol. 2013;79(6):791–9.CrossRefGoogle Scholar
  7. 7.
    Tur J, Alòs M, Iglesias L, Luque L, Colom A, Escudero A, et al. TRAMOMTANA (multidisciplinary treatment of morbid obesity: medication, behavioral therapy, nutritional support, and physical activity). From question to reality in an investigator-initiated clinical trial (II). Endocrinol Nutr. 2011;58(6):299–307.CrossRefPubMedGoogle Scholar
  8. 8.
    Shechter A. Obstructive sleep apnea and energy balance regulation: a systematic review. Sleep Med Rev. 2017;34:59–69.CrossRefPubMedGoogle Scholar
  9. 9.
    van Hout GCM, van Oudheusden I, van Heck GL. Psychological profile of the morbidly obese. Obes Surg. 2004;14(5):579–88.CrossRefPubMedGoogle Scholar
  10. 10.
    Kass AE, Kolko RP, Wilfley DE. Psychological treatments for eating disorders. Curr Opin Psychiatry. 2013;26(6):549–55.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the Management of Overweight and Obesity in adults. J Am Coll Cardiol. 2014;63(25):2985–3023.CrossRefPubMedGoogle Scholar
  12. 12.
    Torgerson JS, Hauptman J, Boldrin MN, Sjöström L. XENical in the prevention of diabetes in obese subjects (XENDOS) study: a randomized study of orlistat as an adjunct to lifestyle changes for the prevention of type 2 diabetes in obese patients. Diabetes Care. 2004;27(1):155–61.CrossRefPubMedGoogle Scholar
  13. 13.
    Zhou Y-H, Ma X-Q, Wu C, Lu J, Zhang S-S, Guo J, et al. Effect of anti-obesity drug on cardiovascular risk factors: a systematic review and meta-analysis of randomized controlled trials. Pereira RI, editor. PLoS One. 2012;7(6):e39062.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Buysschaert B, Aydin S, Morelle J, Hermans MP, Jadoul M, Demoulin N. Weight loss at a high cost: orlistat-induced late-onset severe kidney disease. Diabetes Metab. 2016;42(1):62–4.CrossRefPubMedGoogle Scholar
  15. 15.
    Weir MA, Beyea MM, Gomes T, Juurlink DN, Mamdani M, Blake PG, et al. Orlistat and acute kidney injury: an analysis of 953 patients. Arch Intern Med. 2011;171(7):702.CrossRefGoogle Scholar
  16. 16.
    Li Z, Maglione M, Tu W, Mojica W, Arterburn D, Shugarman LR, et al. Meta-analysis: pharmacologic treatment of obesity. Ann Intern Med. 2005;142(7):532–46.CrossRefPubMedGoogle Scholar
  17. 17.
    Aronne LJ, Wadden TA, Peterson C, Winslow D, Odeh S, Gadde KM. Evaluation of phentermine and topiramate versus phentermine/topiramate extended-release in obese adults. Obesity. 2013;21(11):2163–71.CrossRefPubMedGoogle Scholar
  18. 18.
    Cercato C, Roizenblatt VA, Leança CC, Segal A, Lopes Filho AP, Mancini MC, et al. A randomized double-blind placebo-controlled study of the long-term efficacy and safety of diethylpropion in the treatment of obese subjects. Int J Obes. 2009;33(8):857–65.CrossRefGoogle Scholar
  19. 19.
    Search | Medscape. Drugs and diseases. 2015. Available from: http://search.medscape.com/search/?q=diethylpropion.
  20. 20.
    Allison DB, Gadde KM, Garvey WT, Peterson CA, Schwiers ML, Najarian T, et al. Controlled-release phentermine/Topiramate in severely obese adults: a randomized controlled trial (EQUIP). Obesity. 2012;20(2):330–42.CrossRefPubMedGoogle Scholar
  21. 21.
    Gadde KM, Allison DB, Ryan DH, Peterson CA, Troupin B, Schwiers ML, et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377(9774):1341–52.CrossRefPubMedGoogle Scholar
  22. 22.
    Garvey WT, Ryan DH, Look M, Gadde KM, Allison DB, Peterson CA, et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (SEQUEL): a randomized, placebo-controlled, phase 3 extension study. Am J Clin Nutr. 2012;95(2):297–308.CrossRefPubMedGoogle Scholar
  23. 23.
    Gardin JM, Schumacher D, Constantine G, Davis KD, Leung C, Reid CL. Valvular abnormalities and cardiovascular status following exposure to dexfenfluramine or phentermine/fenfluramine. JAMA. 2000;283(13):1703–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Smith SR, Weissman NJ, Anderson CM, Sanchez M, Chuang E, Stubbe S, et al. Multicenter, placebo-controlled trial of lorcaserin for weight management. N Engl J Med. 2010;363(3):245–56.CrossRefPubMedGoogle Scholar
  25. 25.
    Fidler MC, Sanchez M, Raether B, Weissman NJ, Smith SR, Shanahan WR, et al. A one-year randomized trial of lorcaserin for weight loss in obese and overweight adults: the BLOSSOM trial. J Clin Endocrinol Metab. 2011;96(10):3067–77.CrossRefPubMedGoogle Scholar
  26. 26.
    O’Neil PM, Smith SR, Weissman NJ, Fidler MC, Sanchez M, Zhang J, et al. Randomized placebo-controlled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the BLOOM-DM study. Obesity (Silver Spring). 2012;20(7):1426–36.CrossRefGoogle Scholar
  27. 27.
    Lobmaier P, Kornør H, Kunøe N, Bjørndal A. Sustained-release naltrexone for opioid dependence. Lobmaier P, editor. Cochrane Database Syst Rev. 2008;2:CD006140.Google Scholar
  28. 28.
    Dhillon S, Yang LPH, Curran MP. Bupropion: a review of its use in the management of major depressive disorder. Drugs. 2008;68(5):653–89.CrossRefPubMedGoogle Scholar
  29. 29.
    Greenway FL, Fujioka K, Plodkowski RA, Mudaliar S, Guttadauria M, Erickson J, et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet (London, England). 2010;376(9741):595–605.CrossRefGoogle Scholar
  30. 30.
    Apovian CM, Aronne L, Rubino D, Still C, Wyatt H, Burns C, et al. A randomized, phase 3 trial of naltrexone SR/bupropion SR on weight and obesity-related risk factors (COR-II). Obesity (Silver Spring). 2013;21(5):935–43.CrossRefGoogle Scholar
  31. 31.
    Wadden TA, Foreyt JP, Foster GD, Hill JO, Klein S, O’Neil PM, et al. Weight loss with naltrexone SR/bupropion SR combination therapy as an adjunct to behavior modification: the COR-BMOD trial. Obesity. 2011;19(1):110–20.CrossRefPubMedGoogle Scholar
  32. 32.
    Orexigen Therapeutics announces data from CORDiabetes trial for Contrave. Orexigen therapeutics announces data from CORDiabetes trial for contrave. Available from: http://www.news-medical.net/news/20100628/Orexigen-Therapeutics-announces-data-from-CORDiabetes-trial-for-Contrave.aspx.
  33. 33.
    Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A randomized, controlled trial of 3.0 mg of Liraglutide in weight management. N Engl J Med. 2015;373(1):11–22.CrossRefPubMedGoogle Scholar
  34. 34.
    Wadden TA, Hollander P, Klein S, Niswender K, Woo V, Hale PM, et al. Weight maintenance and additional weight loss with liraglutide after low-calorie-diet-induced weight loss: the SCALE maintenance randomized study. Int J Obes. 2013;37(11):1443–51.CrossRefGoogle Scholar
  35. 35.
    Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, et al. Efficacy of Liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA. 2015;314(7):687–99.CrossRefPubMedGoogle Scholar
  36. 36.
    Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.General Surgery, Digestive Diseases InstituteCleveland Clinic Abu DhabiAbu DhabiUnited Arab Emirates
  2. 2.Cleveland Clinic Lerner College of MedicineCleveland ClinicClevelandUSA
  3. 3.National Diabetes and Obesity Research Institute (NDORI)TraditionUSA

Personalised recommendations