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Chapter-100 Approach to an Obese Patient—Protocols and Plans

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Chowdhury Subhankar
2. Ghosh Sujoy
3. Dutta Deep
ISBN
9789351526476
DOI
10.5005/jp/books/12535_125
Edition
2/e
Publishing Year
2015
Pages
9
Author Affiliations
1. Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India, IPGME & R and SSKM Hospital, Kolkata, West Bengal, India, IPGME and R, Kolkata, West Bengal, India, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, West Bengal, India, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
2. Institute of Postgraduate Medical Education and Research, Kolkata, India, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India, Institute of Postgraduate Medical Education and Research (IPGMER) and Seth Sukhlal Karnani Memorial (SSKM) Hospital, Kolkata, West Bengal, India, Institute of Postgraduate Medical, Education and Research, Kolkata, West Bengal, India, Institute of Post Graduate Medical, Education and Research, Kolkata, West Bengal, India
3. PGIMER and Dr RML Hospital, New Delhi, India, Post Graduate Medical Education and Research and Ram Manohar Lohia Hospital, New Delhi, India, Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital, New Delhi, India, Postgraduate Institute of Medical Education and Research (PGIMER) and Dr Ram Manohar Lohia (RML) Hospital, New Delhi, India, Venkateshwar Hospitals, New Delhi, India, Venkateshwar Hospital, New Delhi, India
Chapter keywords
Obesity, dyslipidemia, sleep apnea, topiramate, lorcaserin, orlistat, bariatric surgery

Abstract

Obesity is becoming a problem of epidemic proportions in our country with the advent of western lifestyles and food habits. The major health risks associated with obesity include diabetes, cardiovascular disease (CVD), hypertension, dyslipidemia, sleep apnea, some cancers, musculoskeletal disease, infertility, disability, dementia, and mortality. The approach to the patients, management, and life style modifications are well explicated. Bariatric surgery and pharmacotherapy recommended in adults with BMI > 35 kg/m2 along with the presence of one or more comorbidities like type 2 diabetes. Lorcaserin, phentermine/topiramate are the drugs used for obesity. The newest combination therapy under investigation for the treatment of obesity is a combination of naltrexone sustained-release plus bupropion sustained release. Complication based approach to obesity is believed to improve long-term outcomes in a better way as compared to just a BMI-based approach. A large number of newer agents have been recently approved, but their long-term outcomes are eagerly awaited.

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