A Review of Unmet Needs in Obesity Management

The prevalence of obesity continues to escalate in the USA; however, there is no consensus regarding the optimal therapy for obesity. For the vast majority of severely obese patients, conventional medical therapies (i.e., diet, exercise, behavioral counseling) often fail over the long term. Existing...

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Bibliographic Details
Published in:Obesity surgery 2012-06, Vol.22 (6), p.956-966
Main Authors: Nguyen, N., Champion, J. K., Ponce, J., Quebbemann, B., Patterson, E., Pham, B., Raum, W., Buchwald, J. N., Segato, G., Favretti, F.
Format: Article
Language:English
Subjects:
Anti-Obesity Agents - therapeutic use
Appetite Depressants - therapeutic use
Behavior Therapy - methods
Behavior Therapy - trends
Body Mass Index
Exercise
Female
Gastric Bypass - methods
Gastrointestinal surgery
Health Behavior
Humans
Male
Medical procedures
Medicine
Medicine & Public Health
Needs Assessment
Obesity
Obesity, Morbid - drug therapy
Obesity, Morbid - rehabilitation
Obesity, Morbid - surgery
Review
Surgery
United States - epidemiology
Weight control
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Summary:The prevalence of obesity continues to escalate in the USA; however, there is no consensus regarding the optimal therapy for obesity. For the vast majority of severely obese patients, conventional medical therapies (i.e., diet, exercise, behavioral counseling) often fail over the long term. Existing pharmacotherapy adjunctive to behavioral therapy has limited effectiveness and an imperfect safety record. In contrast, bariatric surgery has a high degree of weight loss efficacy, yet only a small fraction of the qualifying obese population undergoes these procedures because of the associated perioperative risks and potential late complications. In addition, the role of bariatric surgery is unclear in certain patient populations, such as patients with lower body mass index (BMI, 30–35 kg/m 2 ), the high-risk super-super obese patients (BMI > 60), the morbidly obese adolescent, and obese patients requiring weight reduction in preparation for other procedures, such as orthopedic, transplant, or vascular surgeries. In these circumstances, there is a need for an effective but less invasive treatment to bridge the gap between medical and surgical therapy. This review examines current treatment outcomes, identifies prominent areas of unmet clinical needs, and provides an overview of two minimally invasive “temporary procedures for weight loss” that may eventually address some of the unmet needs in obesity management.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-012-0634-z