2020-10-29 OMA Agenda - Board of Trustees

and polycystic ovarian syndrome. 9 Pharmacotherapy, when used in conjunction with lifestyle therapy, have generally shown a significant increase in weight loss compared to placebo and even greater clinical improvements when adhering to prescribing continuation for “early responders”; pharmacotherapy is typically discontinued after 3-6 months for “non-responders”. 9 Patients who undergo bariatric surgery experience more dramatic (20-30% total weight loss) and sustained weight loss. Significant improvement or remission of obesity-related diseases, such as T2DM and reduced risk for cardiovascular events are noted after bariatric surgery. 30-32 For optimal and early treatment of obesity, the standard of care among primary care providers would include counseling patients with obesity about the dangers of obesity, and available treatment options. Obesity treatment should be initiated as early as possible and escalated as needed. 33 The failure to address obesity as a disease puts the patient at risk for exacerbation of existing obesity-related diseases, and the development of additional health issues. 3. Obesity treatment involves a care continuum, with appropriate escalation of treatment or referral. Our understanding of the perils of obesity, and our increasing fund of knowledge regarding obesity treatment outcomes have allowed significant advances in counseling, pharmacotherapy, and surgical treatment options. It is important to consider obesity treatment as a continuum of care, in which therapy is escalated based on the severity of adiposity-based chronic disease progression and targeting appropriate treatment efficacy in each patient. 8-15 Appropriate referrals to experts in obesity treatment, such as dietitians, endocrinologists, obesity medicine specialists or bariatric surgeons are an important consideration in the escalation of obesity treatment.

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