A living clinical guideline outlines a treatment hierarchy for selected pharmacologic therapies in patients with obesity and selected patients with overweight.
The American College of Physicians conditionally recommends semaglutide and tirzepatide as first-line pharmacologic treatments for weight management in nonpregnant adults with obesity and selected patients with overweight and weight-related comorbidities. These recommendations are based on systematic reviews evaluating various treatment outcomes.
Background
Obesity is a significant public health concern, contributing to various comorbidities and impacting overall health. The ACP's living clinical guideline aims to provide updated recommendations for clinicians managing patients with obesity and overweight.
Data Highlights
The guideline is based on systematic reviews of randomized controlled trials evaluating pharmacologic treatments for obesity, focusing on outcomes such as all-cause mortality, major adverse cardiovascular events, and weight loss.
Key Findings
Semaglutide and tirzepatide are conditionally recommended as first-line treatments for obesity with lifestyle modifications.
Phentermine-topiramate is suggested as a second-line option, with liraglutide and naltrexone-bupropion as third and fourth-line treatments, respectively.
Semaglutide has been shown to reduce all-cause mortality and major adverse cardiovascular events compared to lifestyle modifications alone.
Tirzepatide demonstrated greater weight loss compared to semaglutide in clinical trials.
Liraglutide improved major adverse cardiovascular events but resulted in less weight loss compared to semaglutide and tirzepatide.
Weight regain is common after discontinuation of weight management drugs, and the optimal duration of treatment is uncertain.
Clinical Implications
Clinicians should consider the ACP's recommendations when prescribing pharmacologic treatments for obesity and overweight, ensuring to discuss potential benefits and harms with patients.
Conclusion
The ACP's living clinical guideline provides a structured approach to pharmacologic treatment options for obesity.
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The procedure was performed under a HOPE Act research protocol at an NYU Langone Health center the institution said is among the limited number of US transplant centers equipped and approved to perform HOPE lung transplants.
