Categories
Change Password!
Reset Password!
Comprehensive, individualized assessment—paired with tailored lifestyle interventions, targeted pharmacotherapy, and, when appropriate, surgery—supports effective weight loss, long-term maintenance, and improved health outcomes in patients with obesity across their lifespan.
A narrative review, based on a broad literature search in PubMed, synthesized best-practice recommendations for diagnosing and treating obesity in adults. It emphasized the significance of shared decision-making between individuals and medical care providers, taking into account disease stage, wellness goals, and lifestyle preferences.
Thorough and Targeted Assessment
The first step in effective management is a complete clinical evaluation. This includes a weight history covering lifetime weight patterns, past weight-loss attempts, medical and mental health history, lifestyle behaviors, and barriers to change. A focused physical examination is followed by laboratory testing tailored to the patient—fasting glucose, glycated hemoglobin (HbA1c), lipid profile, thyroid-stimulating hormone, and liver enzymes are common starting points. In some cases, sleep studies or liver imaging are added based on risk factors.
Anthropometric measurements remain central:
When BMI may misclassify risk—such as in athletic or elderly patients—body composition analysis via bioelectrical impedance or plethysmography can assist, though cost, availability, and space requirements restrict routine usage.
Building a Personalized Treatment Plan
A phenotype-guided approach—matching treatment to a patient’s eating behavior, satiety patterns, or metabolic profile—can boost results. For example, some medications work best in emotional eaters, others in patients with poor satiety or low energy expenditure. Social determinants of health—such as access to healthy foods, safe exercise spaces, and financial resources—must be factored into care planning.
The review highlights that obesity medications and lifestyle strategies must continue beyond the initial weight-loss phase to prevent regain. Clinical trials show that discontinuing agents like semaglutide or tirzepatide often results in significant weight regain and loss of cardiometabolic benefits. Regular follow-up is fundamental—monthly during the first 3 months is linked to better outcomes.
Effective obesity care demands more than short-term weight loss. It requires a precise assessment, a tailored combination of lifestyle changes, medications, and possibly surgery, and a commitment to ongoing support that can adapt to each patient’s changing health and goals.
Annals of Medicine
Obesity: assessment and treatment across the care continuum
Robert F Kushner et al.
Comments (0)