Obesity LOs

• Who are appropriate candidates for pharmacotherapy in treatment of obesity

  Patients w/ BMI >30 or BMI >27 w/ comorbidities (HTN, T2DM, high cholesterol) that have failed non-pharm methods alone

  • Should use pharm in ADDITION to lifestyle changes
  • Typically 3-5% greater weight loss than lifestyle changes plus placebo
• What obestiy med is available OTC

  Orlistat (Xenical, Ali)
• What med can be used in combo with torpiramate ER for tx of obesity

  Phentermine (Adipex P)
• What drug therapy is FDA approved for obesity in tx for SHORT term

  Up to 8-12 weeks, Anorexiants (sympathomimetics) - Phentermine (Adipex P)
• What meds are FDA approved for treatment of both obesity and T2DM

  GLP-1 agonists, GIP agonist
• What obesity meds are controlled substances

  • Anorexiants (sympathomimetics) - Phentermine aka Adipex
  • Combo - Phentermine/Topiramate ER
• Obesity med considerations

  
  

  • Heart disease or uncontrolled HTN: AVOID sympathomimetics
  • DM: GLP-1 agonist, GIP analog, and/or SGLT-2 inhibitor
  • Migraines: phentermine-topiramate b/c topiramate effective for tx migraine
  • Smoking cessation: consider naltrexone-bupropion ER
  • Depression: naltrexone-bupropion ER
  • Chronic opioid use: AVOID naltrexone-bupropion ER
  • Hx of substance use: AVOID controlled substances