The new guidelines published by the American Gastroenterological Association states that patients who do not respond adequately to lifestyle interventions alone, should be offered one of four suggested medications to treat obesity.

The recommendations include adults with obesity or overweight with weight-related complications, who have an inadequate response to lifestyle interventions, it is recommended adding pharmacological agents to lifestyle interventions over continuing lifestyle interventions alone. The guideline panel made nine recommendations. AGA suggests the use of semaglutide 2.4mg, or liraglutide 3.9mg, phentermine-topiramate extended-release (ER) and naltrexone-buproprion ER with lifestyle interventions, compared with lifestyle interventions alone and based on moderate-certainty evidence. AGA recommended the use of phentermine and diethylpropion (based on low certainty evidence). All the meds suggested above are recommended for long-term management of overweight and obesity. Also in adults with obesity or overweight with weight-related complications, AGA suggests against the use of orlistat. In adults with BMI between 25 and 40 kg/m2, AGA recommends using Gelesis 100 oral superabsorbent hydrogel only in the context of a clinical trial.

The rise in obesity in the last two decades associated with the significant increase in its complications, including T2D, non-alcoholic steatohepatitis, obstructive sleep apnea, osteoarthritis and certain types of cancers, made the AGA recommendations an urgent need. These guidelines do not impose a standard of care, but rather, they provide the basis for coherent, knowledgeable decisions for patients and health care professionals. This highlights the importance of shared decision-making between HCPs and their patients, especially for conditional recommendations where patients values and preferences are vital to consider and critical for their compliance. These guidelines also set the stage for enhancing the effectiveness and efficiency of life-style interventions including nutrition and dietetics to help patients achieve their goals faster and more consistently.

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New Guidelines for Obesity