Treatment Strategies for Obesity


  • V. PANKIV Department of Preventive Endocrinology of Ukrainian Scientific Centre of Endocrine Surgery, Kyiv, Ukraine



obesity, type 2 diabetes mellitus, treatment


Obesity is a disease that is defined as the accumulation of excessive amounts of body fat and is associated with increased risk of serious illness, disability, and death. Treatment options are determined based on the body mass index, waist circumference, and adverse health consequences the patient is experiencing or is at an increased risk for facing in the future. Although endocrinologists are uniquely positioned to treat one of the major consequences of our current obesity epidemic, type 2 diabetes, we also need to be positioned and prepared to effectively treat one of its major causes — obesity. Type 2 diabetes and obesity are very much intertwined. Treatment of each disease affects the other. For these reasons, endocrinologists need to be experts in the treatment of obesity as well as diabetes. They should keep up with advances in obesity treatment including lifestyle, pharmaceutical, and surgical strategies. These strategies offer opportunities for improving the overall treatment for our obese patients today and will continue to improve and expand over the next decade.


Flegal K.M., Carroll M.D., Kit B.K., Ogden C.L. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010 // JAMA. — 2012. — Vol. 307. — P. 491-497.

Wyatt H.R. Update on treatment strategies for obesity // J. Clin. Endocrinol. Metab. — 2013. — Vol. 98 (4). — P. 1299-1306.

Bleich S.N., Bennett W.L., Gudzune K.A., Cooper L.A. Impact of physician BMI on obesity care and beliefs // Obesity. — 2012. — Vol. 20. — P. 999-1005.

Meeuwsen S., Horgan G.W., Elia M. The relationship between BMI and percent body fat, measured by bioelectrical impedance, in a large adult sample is curvilinear and influenced by age and sex // Clin. Nutr. — 2010. — Vol. 29. — P. 560-566.

Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults — the evidence report. National Institutes of Health // Obes. Res. — 1998. — Vol. 6 (Suppl. 2). — P. 51-209.

Wadden T.A., Webb V.L., Moran C.H., Bailer B.A. Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy // Circulation. — 2012. — Vol. 125. — P. 1157-1170.

Sacks F.M., Bray G.A., Carey V.J. et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates // N. Engl. J. Med. — 2009. — Vol. 360. — P. 859-873.

Ebbeling C.B., Swain J.F., Feldman H.A. et al. Effects of dietary composition on energy expenditure during weight-loss maintenance // JAMA. — 2012. — Vol. 307. — P. 2627-2634.

Sumithran P., Prendergast L.A., Delbridge E. et al. Long-term persistence of hormonal adaptations to weight loss // N. Engl. J. Med. — 2011. — Vol. 365. — P. 1597-1604.

Donnelly J.E., Blair S.N., Jakicic J.M. et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults // Med. Sci. Sports Exerc. — 2009. — Vol. 41. — P. 459-471.

Mekary R.A., Feskanich D., Hu F.B. et al. Physical activity in relation to long-term weight maintenance after intentional weight loss in premenopausal women // Obesity (Silver Spring). — 2010. — Vol. 18. — P. 167-174.

O’Neil P.M., Smith S.R., Weissman N.J. et al. Randomized placebo-controlled clinical trial of lorcaserin for weight loss in type 2 diabetes mellitus: the BLOOM-DM study // Obesity (Silver Spring). — 2012. — Vol. 20. — P. 1426-1436.

Allison D.B., Gadde K.M., Garvey W.T. et al. Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP) // Obesity (Silver Spring). — 2012. — Vol. 20. — P. 330-342.

Gadde K.M., Allison D.B., Ryan D.H. et al. Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial // Lancet. — 2011. — Vol. 377. — P. 1341-1352.

Garvey W.T., Ryan D.H., Look M. et al. Two-year sustained weight loss and metabolic benefits with controlled-release phentermine/topiramate in obese and overweight adults (­SEQUEL): a randomized, placebo-controlled, phase 3 extension study // Am. J. Clin. Nutr. — 2012. — Vol. 95. — P. 297-308.

Greenway F.L., Fujioka K., Plodkowski R.A. et al. Effect of naltrexone plus bupropion on weight loss in overweight and obese adults (COR-I): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial // Lancet. — 2010. — Vol. 376. — P. 595-605.

Katsiki N., Hatzitolios A.I., Mikhailidis D.P. Naltrexone sustained-release (SR) + bupropion SR combination therapy for the treatment of obesity: «a new kid on the block»? // Ann. Med. — 2011. — Vol. 43. — P. 249-258.

Dixon J.B., Zimmet P., Alberti K.G., Rubino F. Bariatric surgery: an IDF statement for obese type 2 diabetes // Diabet. Med. — 2011. — Vol. 28. — P. 628-642.

Mingrone G., Panunzi S., De Gaetano A. et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes // N. Engl. J. Med. — 2012. — Vol. 366. — P. 1577-1585.

Schauer P.R., Kashyap S.R., Wolski K. et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes // N. Engl. J. Med. — 2012. — Vol. 366. — P. 1567-1576.

Kumar N., Thompson C.C. Endoscopic solutions for weight loss // Curr. Opin. Gastroenterol. — 2011. — Vol. 27. — P. 407-411.