Naguib Abdelrehim
University Hospital Sharjah, UAE
Title: Does medications work in childhood obesity
Biography
Biography: Naguib Abdelrehim
Abstract
Does medications work in childhood obesity; Strategies and principles for dealing with chronic weight management in children and adolescents is mainly accomplished through Lifestyle and behavioral interventions including Dietary change, increased physical activity, Decreased sedentary behaviors, and Improved sleeping pattern. Failure of this approach leading to consider other interventions mainly Pharmacotherapy, endoscopic procedures and Bariatric surgery.
Until recently, there has been a treatment gap between lifestyle modifications and bariatric surgery in terms of available, highly effective medications for obesity treatment. Now, this treatment gap is being filled with new medications. This is a truly exciting time for our patients with obesity.
FDA and EMA approved Anti-obesity medications include Orlistat, Phentermine/Topirmate, Bupropion/Naltrexone, Liraglutide 3 mg and Semaglutide 2.4 mg.
These medications don’t work by themselves. They reinforce the patient’s intention to reduce food intake. They are biologic adjuncts to behavior change. The goal of anti-obesity medications is to decrease the body fat mass set point, as the body fat mass set point is decreased or reset, weight loss will follow. Most the anti-obesity medications work in the brain.
As with any medication, if there is not a satisfactory response, these medications should be stopped. When satisfactory weight loss occurs and then plateaus, this is not a sign of tolerance or loss of efficacy. In clinical trials, when the drug is withdrawn, weight regain occurs. Maintenance of lost weight is a sign of success. The prescribers should be aware of side effects of these medications before prescribing them.
Because obesity is a Heterogeneous disease the response to anti-obesity medications is variable. Some patients may have an inadequate response - but in others, the medication may prove to be effective, or even highly effective. Obesity is also a complex disease; therefore combination pharmacotherapy is often needed, just as it may be needed for any other complex disease. Finally, Obesity is a chronic disease, necessitating continued, lifelong treatment.