Abstract
OBJECTIVE: Modest weight loss (5%-10%) is clinically meaningful in patients with overweight or obesity. However, greater weight loss may be required to achieve improvements in or remission of certain weight-related complications. Therefore, this study reviewed the effect of large weight loss (≥10%). Most studies reporting large weight loss and relevant outcomes used bariatric surgery or lifestyle modifications.
RESULTS: Benefits of large weight loss were observed in patients with various overweight- or obesity-related complications, including improvements in comorbidities such as type 2 diabetes and hypertension. Improvements in glucose metabolism and cardiovascular risk factors were observed in patients who achieved large weight loss through lifestyle interventions or pharmacotherapy (phentermine/topiramate 15/92 mg once daily or subcutaneous semaglutide 2.4 mg once weekly). Other benefits associated with large weight loss included reduced cancer risk and improvements in knee osteoarthritis, sleep apnea, fertility-related end points, and health-related quality of life. While costly, bariatric surgery is currently the most cost-effective intervention, although most weight-management programs are deemed cost-effective.
CONCLUSIONS: Overall, large weight loss has a major beneficial impact on overweight- and obesity-related complications. Large weight loss should be the main treatment target when modest weight loss has had insufficient effects on obesity-related complications and for patients with severe obesity.
Original language | English |
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Pages (from-to) | 802-840 |
Number of pages | 39 |
Journal | Obesity |
Volume | 30 |
Issue number | 4 |
Early online date | 25 Mar 2022 |
DOIs | |
Publication status | Published - Apr 2022 |
Bibliographical note
Funding Information:Medical writing support was funded by Novo Nordisk A/S. Novo Nordisk A/S conducted initial literature searches and had a role in the review of the manuscript for scientific accuracy.
AAT reports grants, personal fees, and/or nonfinancial support from AstraZeneca plc; Bharat Pharmaceuticals; Boehringer Ingelheim; Bristol‐Myers Squibb; Eli Lilly and Company; Gilead Sciences, Inc.; Impeto Medical; Janssen Pharmaceuticals; Merck Sharp and Dohme; Napp Pharmaceuticals Ltd.; Nestlé S.A.; Novo Nordisk A/S; ResMed; and Sanofi S.A. AAT is currently employed by Novo Nordisk A/S as International Medical Vice President for Obesity in Clinical Drug Development. The manuscript was written before AAT joined Novo Nordisk A/S. JM is a consultant for Novo Nordisk A/S.
Publisher Copyright:
© 2022 The Obesity Society.
Keywords
- Anti-Obesity Agents/therapeutic use
- Diabetes Mellitus, Type 2/drug therapy
- Humans
- Obesity/drug therapy
- Overweight/drug therapy
- Phentermine/therapeutic use
- Quality of Life
- Topiramate/therapeutic use
- Weight Loss
ASJC Scopus subject areas
- Endocrinology
- Nutrition and Dietetics
- Medicine (miscellaneous)
- Endocrinology, Diabetes and Metabolism