Pharmacologic Interventions for Adults with Obesity: Guideline Topline for Primary Care
The American Gastroenterological Association (AGA) released new evidence-based guidelines recommending long-term pharmacologic therapy for adults with obesity who do not respond adequately to lifestyle interventions alone. In total, the AGA made 9 recommendations. Which antiobesity medications received an AGA endorsement? Below, an at-a-glance summary of the new guidance.
1. In adults with obesity or overweight with weight-related complications, who have had an inadequate response to lifestyle interventions, the AGA recommends adding pharmacologic agents to lifestyle interventions over continuing lifestyle interventions alone.
2. In adults with obesity or overweight with weight-related complications, the AGA suggests using semaglutide 2.4 mg with lifestyle modifications, compared with lifestyle modifications alone.
3. In adults with obesity or overweight with weight-related complications, the AGA suggests using liraglutide 3.0 mg with lifestyle modifications, compared with lifestyle modifications alone.
4. In adults with obesity or overweight with weight-related complications, the AGA suggests using phentermine-topiramate ER with lifestyle modifications, compared with lifestyle modifications alone.
5. In adults with obesity or overweight with weight-related complications, the AGA suggests using naltrexone-bupropion ER with lifestyle modifications, compared with lifestyle modifications alone.
6. In adults with obesity or overweight with weight-related complications, AGA suggests against the use of orlistat.
- Comment: Patients who place a high value on the potential small weight loss benefit and low value on GI adverse effects may reasonably choose treatment with orlistat.
7. In adults with obesity or overweight with weight-related complications, the AGA suggests using phentermine with lifestyle modifications, compared with lifestyle modifications alone.
8. In adults with obesity or overweight with weight-related complications, the AGA suggests using diethylpropion with lifestyle modifications, compared with lifestyle modifications alone.
9. In adults with BMI between 25 and 40 kg/m2, the AGA recommends using Gelesis100 oral superabsorbent hydrogel only in the context of a clinical trial.
